Healthcare Provider Details

I. General information

NPI: 1083169924
Provider Name (Legal Business Name): SARAH SUSAN MARSH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH SUSAN OBERLIN

II. Dates (important events)

Enumeration Date: 08/21/2016
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 POWERS BLVD
CLEVELAND OH
44129-5437
US

IV. Provider business mailing address

7757 AUBURN RD STE 15
PAINESVILLE OH
44077-9604
US

V. Phone/Fax

Practice location:
  • Phone: 440-743-2001
  • Fax:
Mailing address:
  • Phone: 440-709-9150
  • Fax: 440-354-7420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.345631
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.019331
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: