Healthcare Provider Details

I. General information

NPI: 1912744756
Provider Name (Legal Business Name): SARAH J YANCEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 WATERS AVE STE 400
SAVANNAH GA
31404-6220
US

IV. Provider business mailing address

4790 WATERS AVE STE 400
SAVANNAH GA
31404-6220
US

V. Phone/Fax

Practice location:
  • Phone: 912-866-1220
  • Fax: 855-538-6936
Mailing address:
  • Phone: 912-866-1220
  • Fax: 855-538-6936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13030
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: