Provider Demographics
NPI:1083803779
Name:SARGENT, SARA (CNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SARGENT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 SHERIDAN DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1381
Mailing Address - Country:US
Mailing Address - Phone:740-654-0232
Mailing Address - Fax:740-654-9794
Practice Address - Street 1:1550 SHERIDAN DR
Practice Address - Street 2:SUITE 202
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1381
Practice Address - Country:US
Practice Address - Phone:740-654-0232
Practice Address - Fax:740-654-9794
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP09675363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner