Provider Demographics
NPI:1316549397
Name:NICHOLS, SARAH LEE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LEE
Last Name:NICHOLS
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:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:SAINT PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:43072-0029
Mailing Address - Country:US
Mailing Address - Phone:937-980-4022
Mailing Address - Fax:
Practice Address - Street 1:218 N SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:SAINT PARIS
Practice Address - State:OH
Practice Address - Zip Code:43072-7707
Practice Address - Country:US
Practice Address - Phone:937-980-4022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health