Healthcare Provider Details

I. General information

NPI: 1982503504
Provider Name (Legal Business Name): MS. YOLANDA ANN SAPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 LIVELY ST
AUGUSTA GA
30906-3461
US

IV. Provider business mailing address

2024 LIVELY ST
AUGUSTA GA
30906-3461
US

V. Phone/Fax

Practice location:
  • Phone: 706-394-1323
  • Fax:
Mailing address:
  • Phone: 706-394-1323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License NumberLCB20210001805
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: