Provider Demographics
NPI:1114459211
Name:VOGEL, SANDRA ANN (RN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANN
Last Name:VOGEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13377 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-7810
Mailing Address - Country:US
Mailing Address - Phone:440-340-5558
Mailing Address - Fax:440-340-5575
Practice Address - Street 1:13377 SMITH RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-7810
Practice Address - Country:US
Practice Address - Phone:440-340-5558
Practice Address - Fax:440-340-5575
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH156680163WA0400X
OHLCDCII.85286101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN.156680OtherLICENSE