Provider Demographics
NPI:1225633886
Name:ZACIEWSKI, SARA ASHLEY
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:ASHLEY
Last Name:ZACIEWSKI
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 1:29060 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43447-9613
Mailing Address - Country:US
Mailing Address - Phone:419-349-0214
Mailing Address - Fax:
Practice Address - Street 1:1900 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1214
Practice Address - Country:US
Practice Address - Phone:419-423-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028015363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner