Healthcare Provider Details

I. General information

NPI: 1235449844
Provider Name (Legal Business Name): SARAH K. HARRIS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 WINDY HILL ROAD WELLSTAR PSYCHIATRY, LLC
MARIETTA GA
30067
US

IV. Provider business mailing address

2933 JUDYLYN DRIVE
DECATUR GA
30033-6005
US

V. Phone/Fax

Practice location:
  • Phone: 770-644-1570
  • Fax: 770-644-1576
Mailing address:
  • Phone: 404-292-4405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN167607
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: