Healthcare Provider Details

I. General information

NPI: 1376435339
Provider Name (Legal Business Name): SARAH CAROLYN OSWALD GADDY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH CAROLYN OSWALD

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1120 15TH ST
AUGUSTA GA
30912-0004
US

V. Phone/Fax

Practice location:
  • Phone: 762-375-2466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberRN275429
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: