Basic Information
| Provider Information | |||||||||
| NPI: | 1720250426 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PROPST | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | LOUDERMILK | ||||||||
| NamePrefix: | |||||||||
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| Credential: | PH.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | LOUDERMILK | ||||||||
| OtherFirstName: | SARA | ||||||||
| OtherMiddleName: | MICHELLE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6350 W ANDREW JOHNSON HWY | ||||||||
| Address2: | DEPARTMENT 100 | ||||||||
| City: | TALBOTT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378778605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003553565 | ||||||||
| FaxNumber: | 4237142355 | ||||||||
| Practice Location | |||||||||
| Address1: | 10731 CHAPMAN HWY | ||||||||
| Address2: | |||||||||
| City: | SEYMOUR | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378654765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655730698 | ||||||||
| FaxNumber: | 8655733174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2008 | ||||||||
| LastUpdateDate: | 08/21/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 3510 | NC | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 390200000X | TN | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 103TC0700X | P3027 | TN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.