Healthcare Provider Details

I. General information

NPI: 1699483644
Provider Name (Legal Business Name): SARAH DEUTCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 GLAZIER RD
FT WRIGHT KY
41011-2726
US

IV. Provider business mailing address

7 GLAZIER RD
FT WRIGHT KY
41011-2726
US

V. Phone/Fax

Practice location:
  • Phone: 859-760-4363
  • Fax:
Mailing address:
  • Phone: 859-760-4363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1129630
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.375303
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: