Provider Demographics
NPI:1578223863
Name:ALTVATER, SARAH JEAN (CNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:ALTVATER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3246 SOUREK RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2716
Mailing Address - Country:US
Mailing Address - Phone:330-696-9792
Mailing Address - Fax:
Practice Address - Street 1:3246 SOUREK RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2716
Practice Address - Country:US
Practice Address - Phone:330-696-9792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0030026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily