Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AG07190298 | GA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | AG07190298 | GA |
NPI | 1023666138 |
---|---|
Provider Name | Sherline Sauveur |
First Address | Hampton, GA 30228-6385 |
Second Address | Hampton, GA 30228-6385 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2019 |
Last Update Date | 01/09/2019 |