Provider Demographics
NPI:1295129385
Name:KINCAID, SARAH R (APRN-CNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:KINCAID
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:EICHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-685-9994
Mailing Address - Fax:614-685-9993
Practice Address - Street 1:181 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1779
Practice Address - Country:US
Practice Address - Phone:614-685-9994
Practice Address - Fax:614-685-9993
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17374-NP363LF0000X
OHAPRN.CNP.17374363L00000X
OHRN.381523163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0139230Medicaid
OH0139230Medicaid