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NPI Code Detail

MEDICARE: SARAH COLEGROVE MASIEWICZ MSN, APRN, FNP, ENP

MEDICARE: SARAH COLEGROVE MASIEWICZ MSN, APRN, FNP, ENP
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
1363L00000XNurse PractitionerRN316869GA

General Provider Information

NPI Number : 1811716251
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH COLEGROVE MASIEWICZ MSN, APRN, FNP, ENP
Provider Business Mailing Address
First Line : PO BOX 1060
Second Line :
City : OAKWOOD
State : GA
Zip : 30566-0018
Country : US
Telephone Number : 770-219-8420
Fax Number :
Provider Business Practice Location Address
First Line : 12 7TH ST
Second Line :
City : AUBURN
State : GA
Zip : 30011-3202
Country : US
Telephone Number : 717-517-0617
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2024
Last Update Date : 12/03/2024

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