Provider Demographics
NPI:1336443993
Name:SWEET, SARA ANNE (CNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANNE
Last Name:SWEET
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 1:3535 PENTAGON BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1705
Mailing Address - Country:US
Mailing Address - Phone:937-429-7350
Mailing Address - Fax:937-431-7400
Practice Address - Street 1:3535 PENTAGON BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-1705
Practice Address - Country:US
Practice Address - Phone:937-429-7350
Practice Address - Fax:937-431-7400
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12067-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3127520Medicaid
OHNP40131Medicare PIN
OH3127520Medicaid