Healthcare Provider Details

I. General information

NPI: 1215749239
Provider Name (Legal Business Name): SARA WOURMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3188 BELLEVUE AVE
CINCINNATI OH
45219-2369
US

IV. Provider business mailing address

4127 SIBLEY AVE
CINCINNATI OH
45236-3737
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-5500
  • Fax:
Mailing address:
  • Phone: 937-684-2337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.447799
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: