Provider Demographics
NPI:1851096671
Name:OBERHAUS, SARA ANN (STNA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:OBERHAUS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N GRANT ST
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-1769
Mailing Address - Country:US
Mailing Address - Phone:419-436-9071
Mailing Address - Fax:
Practice Address - Street 1:221 N GRANT ST
Practice Address - Street 2:
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-1769
Practice Address - Country:US
Practice Address - Phone:419-619-1059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRK391569374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide