Provider Demographics
NPI:1265866651
Name:BOOTH, SARAH ANNE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANNE
Last Name:BOOTH
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:BOZICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-433-1777
Mailing Address - Fax:330-305-5001
Practice Address - Street 1:6046 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7616
Practice Address - Country:US
Practice Address - Phone:330-433-1777
Practice Address - Fax:330-305-5001
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14794-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner