Healthcare Provider Details

I. General information

NPI: 1720915200
Provider Name (Legal Business Name): SARAH TANBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

800 N FANT ST
ANDERSON SC
29621-5708
US

IV. Provider business mailing address

2506 EDGEWOOD AVE
ANDERSON SC
29625-2437
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number269152
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: