Provider Demographics
NPI:1912624313
Name:REDDING, SARA ELIZABETH (INDEPENDENT PROVIDER)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:REDDING
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:43151
Mailing Address - Country:US
Mailing Address - Phone:513-446-4470
Mailing Address - Fax:
Practice Address - Street 1:90 SOUTH STREET
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:OH
Practice Address - Zip Code:43151-4315
Practice Address - Country:US
Practice Address - Phone:513-446-4470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRY670449376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker