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General NPI Number Information
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NPI Number | 1790305852
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Entity Type | Individual
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Provider Name | SARA MICAH EDDLEMAN
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Gender | Female
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Dates
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Enumeration Date | 04/19/2020
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 848 ADAMS AVE
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City | MEMPHIS
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State | TN
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Zip | 38103-2816
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Country | US
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Telephone | 866-870-5570
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Fax |
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Provider Business Mailing Address
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Address Line | 1593 MCKENAS WAY CV
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City | HERNANDO
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State | MS
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Zip | 38632-2203
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Country | US
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Telephone |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 27765
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 899452
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 974810-01
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License Number State | NY
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