Marietta, Sara

Marietta, Sara is an sole proprietor health care provider with primary practice located at 450 N Hyatt St Ste 202 , Tipp City OH 45371-1433. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Marietta, Sara can be contacted via phone (937) 669-9978.

Contact Information

Primary practice address
450 N Hyatt St Ste 202 Tipp City OH 45371-1433
Phone: (937) 669-9978
Fax: (937) 669-1266
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN340213 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X COA.18375NP Ohio

Profile Details

NPI number 1235500646
LBN Legal business name Marietta, Sara
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2015
Last updated Jan 23rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235500646 NPPES
Ohio MEDICAID 0153141

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