Provider Demographics
NPI:1407101058
Name:SAWTELLE, MARY ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANN
Last Name:SAWTELLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 GREEN BRANCH RD NE
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-9722
Mailing Address - Country:US
Mailing Address - Phone:740-605-4637
Mailing Address - Fax:
Practice Address - Street 1:3661 GREEN BRANCH RD NE
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-9722
Practice Address - Country:US
Practice Address - Phone:740-605-4637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN332322163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical