Provider Demographics
NPI:1134595242
Name:DIRK, SARAH O (NP-C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:O
Last Name:DIRK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:SEIDMAN 3
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-286-3340
Mailing Address - Fax:216-286-5776
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:SEIDMAN 3
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-286-3340
Practice Address - Fax:216-286-5776
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17950-NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA.17950-NPOtherOHIO BOARD OF NURSING