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General NPI Number Information
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NPI Number | 1992354096
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Entity Type | Individual
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Provider Name | MRS. SARAH MARIE MCCONNAUGHHAY
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Gender | Female
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 29 TAYLOR AVE STE 101
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City | CROSSVILLE
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State | TN
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Zip | 38555-4536
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Country | US
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Telephone | 931-484-6061
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Fax |
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Provider Business Mailing Address
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Address Line | 445 GRACE HILL DR
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City | CROSSVILLE
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State | TN
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Zip | 38571-1626
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Country | US
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Telephone | 931-210-4144
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 6025
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License Number State | TN
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