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General NPI Number Information
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NPI Number | 1043037278
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Entity Type | Individual
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Provider Name | SANA ALI NP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 4120 FIVE FORKS TRICKUM RD SW
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City | LILBURN
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State | GA
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Zip | 30047-3133
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Country | US
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Telephone | 770-255-3491
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 FIELDGREEN CT
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City | DALTON
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State | GA
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Zip | 30720-5806
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Country | US
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Telephone | 706-980-9978
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN279594
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License Number State | GA
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