Provider Demographics
NPI:1598521411
Name:SAWYER, LANITRA T
Entity Type:Individual
Prefix:
First Name:LANITRA
Middle Name:T
Last Name:SAWYER
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 1:50 KIPATRICK DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-3527
Mailing Address - Country:US
Mailing Address - Phone:614-687-8982
Mailing Address - Fax:
Practice Address - Street 1:50 KIPATRICK DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-3527
Practice Address - Country:US
Practice Address - Phone:614-687-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide