Healthcare Provider Details

I. General information

NPI: 1861319089
Provider Name (Legal Business Name): SARAH SUTTON LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 VICTORY DR
SWAINSBORO GA
30401-3235
US

IV. Provider business mailing address

124 VICTORY DR
SWAINSBORO GA
30401-3235
US

V. Phone/Fax

Practice location:
  • Phone: 478-237-5506
  • Fax: 478-419-1070
Mailing address:
  • Phone: 478-237-5506
  • Fax: 478-419-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP289401
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: