Provider Demographics
NPI:1689846594
Name:RICKARD, SARA RICHARDSON (CRNP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:RICHARDSON
Last Name:RICKARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2410 AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-3283
Mailing Address - Country:US
Mailing Address - Phone:256-386-0808
Mailing Address - Fax:256-389-8904
Practice Address - Street 1:2410 AVALON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-3283
Practice Address - Country:US
Practice Address - Phone:256-386-0808
Practice Address - Fax:256-386-0808
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-101158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily