Provider Demographics
NPI:1982188439
Name:GUISINGER, SARAH CATHERINE (PA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CATHERINE
Last Name:GUISINGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 HICKORY HOLLOW PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3389
Mailing Address - Country:US
Mailing Address - Phone:615-891-2070
Mailing Address - Fax:
Practice Address - Street 1:4998 CROSSINGS CIR STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-0018
Practice Address - Country:US
Practice Address - Phone:615-553-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
CA59484363A00000X
NMPA2021-0048363A00000X
ALPA.1397363A00000X
FLPA9114724363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2206883Medicaid