Provider Demographics
NPI:1245619444
Name:CHARTRANT, SARA DOLORES (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:DOLORES
Last Name:CHARTRANT
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 1:17 CHIPPEWA DR
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:OH
Mailing Address - Zip Code:44846-9762
Mailing Address - Country:US
Mailing Address - Phone:440-570-9831
Mailing Address - Fax:
Practice Address - Street 1:17 CHIPPEWA DR
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:OH
Practice Address - Zip Code:44846-9762
Practice Address - Country:US
Practice Address - Phone:440-570-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH153611164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse