Provider Demographics
NPI:1376827279
Name:BERRIDGE, SARAH JANE (LPN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:BERRIDGE
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 1:6194 HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:OH
Mailing Address - Zip Code:43342
Mailing Address - Country:US
Mailing Address - Phone:740-494-2527
Mailing Address - Fax:
Practice Address - Street 1:6194 HUGHES RD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:OH
Practice Address - Zip Code:43342-9623
Practice Address - Country:US
Practice Address - Phone:740-494-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145282-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse