Healthcare Provider Details

I. General information

NPI: 1285867051
Provider Name (Legal Business Name): SARAH POPPELL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 08/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11706 MERCY BLVD STE 10
SAVANNAH GA
31419-1751
US

IV. Provider business mailing address

11706 MERCY BLVD STE 10
SAVANNAH GA
31419-1751
US

V. Phone/Fax

Practice location:
  • Phone: 912-920-0055
  • Fax: 912-920-3367
Mailing address:
  • Phone: 912-920-0055
  • Fax: 912-920-3367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WU0100X
TaxonomyUrology Registered Nurse
License NumberRN160078
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: