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NPI Code Detail

MEDICARE: SARAH BRICENO FAMBROUGH

MEDICARE: SARAH BRICENO FAMBROUGH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN259000GA

General Provider Information

NPI Number : 1154036341
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH BRICENO FAMBROUGH
Provider Business Mailing Address
First Line : 1101 OCILLA RD
Second Line :
City : DOUGLAS
State : GA
Zip : 31533-2262
Country : US
Telephone Number : 912-384-1900
Fax Number :
Provider Business Practice Location Address
First Line : 1101 OCILLA RD
Second Line :
City : DOUGLAS
State : GA
Zip : 31533-2262
Country : US
Telephone Number : 912-384-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2023
Last Update Date : 05/01/2026

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Directions to “ SARAH BRICENO FAMBROUGH ” Practice Location

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