Provider Demographics
NPI:1194226910
Name:DORSEY, SAHARA DAWN (BC-FNP)
Entity Type:Individual
Prefix:
First Name:SAHARA
Middle Name:DAWN
Last Name:DORSEY
Suffix:
Gender:F
Credentials:BC-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 WARDS CORNER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6966
Mailing Address - Country:US
Mailing Address - Phone:513-707-4041
Mailing Address - Fax:513-576-1020
Practice Address - Street 1:500 S 5TH ST STE 202
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:OH
Practice Address - Zip Code:45176-1017
Practice Address - Country:US
Practice Address - Phone:513-636-5005
Practice Address - Fax:513-436-0470
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH362755163W00000X
OH022389363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0266639Medicaid