| Doctor Name: | MS. SARA ANN FREDERICKSEN |
| NPI Number: | 1003057167 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP |
| License Number: | 13961 |
| Business Practice Address: | 501 19th St Suite 501 Knoxville, TN - 379161854 |
| Business Phone Number: | 8655463181 |
| Business Fax Number: | 8652128852 |
| Mailing Address: | 501 19th St, Suite 501 KNOXVILLE |
| State: | TN |
| Postal Code: | 379161854 |
| Phone Number: | 8655463181 |
| Fax Number: | 8652128852 |
| NPI Enumeration Date: | 03/18/2009 |
| NPI Last Update Date: | 05/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 13961 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |