Provider Demographics
NPI:1083361687
Name:SANOR, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SANOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-0429
Mailing Address - Country:US
Mailing Address - Phone:330-424-9573
Mailing Address - Fax:330-424-0877
Practice Address - Street 1:40722 STATE ROUTE 154
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-8500
Practice Address - Country:US
Practice Address - Phone:330-424-9573
Practice Address - Fax:330-424-0877
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.118163.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLPN.118163.MEDSOtherOHIO NURSING BOARD