Healthcare Provider Details

I. General information

NPI: 1447532833
Provider Name (Legal Business Name): SARAH RAYMOND CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # C-25
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # C-25
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-3075
  • Fax: 216-636-5403
Mailing address:
  • Phone: 216-445-3075
  • Fax: 216-636-5403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCOA.12350-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.369479-COA1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: