Provider Demographics
NPI:1659095107
Name:HADDIX, SARAH RENEE
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:RENEE
Last Name:HADDIX
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:RENEE
Other - Last Name:GILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:288 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-1239
Mailing Address - Country:US
Mailing Address - Phone:304-476-0602
Mailing Address - Fax:
Practice Address - Street 1:288 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-1239
Practice Address - Country:US
Practice Address - Phone:304-476-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant