Healthcare Provider Details

I. General information

NPI: 1154398428
Provider Name (Legal Business Name): SARAH GEDEON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 ARCH ST STE 2H
AKRON OH
44304-1423
US

IV. Provider business mailing address

PO BOX 26010
AKRON OH
44319-6010
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-4100
  • Fax:
Mailing address:
  • Phone: 888-328-4534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN279692
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: