Provider Demographics
NPI:1669671186
Name:SADUR, MARY KAY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KAY
Last Name:SADUR
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 1:4483 CHRISTINA LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1169
Mailing Address - Country:US
Mailing Address - Phone:614-532-0222
Mailing Address - Fax:
Practice Address - Street 1:4483 CHRISTINA LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-1169
Practice Address - Country:US
Practice Address - Phone:614-532-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN096205164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse