Provider Demographics
NPI:1235787961
Name:FIEGER, SARA (PA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FIEGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 N BROADWAY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-1762
Mailing Address - Country:US
Mailing Address - Phone:513-932-1936
Mailing Address - Fax:513-932-3105
Practice Address - Street 1:1470 N BROADWAY ST STE 100
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1762
Practice Address - Country:US
Practice Address - Phone:513-932-1936
Practice Address - Fax:513-932-3105
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006071RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant