Provider Demographics
NPI:1013322643
Name:BELDON, SARA MARIE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARIE
Last Name:BELDON
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 1:1813 NAGEL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-6401
Mailing Address - Country:US
Mailing Address - Phone:440-937-4600
Mailing Address - Fax:440-937-4605
Practice Address - Street 1:1813 NAGEL RD STE 500
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-6401
Practice Address - Country:US
Practice Address - Phone:440-937-4600
Practice Address - Fax:440-937-4605
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.15879363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0121025Medicaid