Healthcare Provider Details

I. General information

NPI: 1023695327
Provider Name (Legal Business Name): SARAH TIMKO APRN.CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MIRANOVA PL
COLUMBUS OH
43215-5078
US

IV. Provider business mailing address

3710 E SMITH RD
MEDINA OH
44256-8768
US

V. Phone/Fax

Practice location:
  • Phone: 614-321-9743
  • Fax: 614-647-0070
Mailing address:
  • Phone: 330-321-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0028210
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: