Provider Demographics
NPI:1770230187
Name:LANE, SARAH CHRISTINE
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:CHRISTINE
Last Name:LANE
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 1:9294 STATE ROUTE 44 LOT A30
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:OH
Mailing Address - Zip Code:44255-9792
Mailing Address - Country:US
Mailing Address - Phone:330-281-0111
Mailing Address - Fax:
Practice Address - Street 1:9294 STATE ROUTE 44 LOT A30
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:OH
Practice Address - Zip Code:44255-9792
Practice Address - Country:US
Practice Address - Phone:330-281-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-05
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide