Provider Demographics
NPI:1952521965
Name:COLLINS, SARAH NICOLE (CNA)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:NICOLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-3214
Mailing Address - Country:US
Mailing Address - Phone:513-376-4513
Mailing Address - Fax:
Practice Address - Street 1:545 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-3214
Practice Address - Country:US
Practice Address - Phone:513-376-4513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN8971485509374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2502821Medicaid