Healthcare Provider Details

I. General information

NPI: 1710389903
Provider Name (Legal Business Name): SARAH ANNETTE RANSOM PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ANNETTE OAKES

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-4392
US

IV. Provider business mailing address

3005 AMBROSE AVE
NASHVILLE TN
37207-4709
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0761
  • Fax:
Mailing address:
  • Phone: 844-673-6968
  • Fax: 844-673-6968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9107992
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: