Provider Demographics
NPI:1083918965
Name:SARBAUGH, SCARLETT AMBER (LPN)
Entity Type:Individual
Prefix:
First Name:SCARLETT
Middle Name:AMBER
Last Name:SARBAUGH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-1595
Mailing Address - Country:US
Mailing Address - Phone:937-279-4745
Mailing Address - Fax:
Practice Address - Street 1:96 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-1595
Practice Address - Country:US
Practice Address - Phone:937-279-4745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH136702164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse