Healthcare Provider Details

I. General information

NPI: 1376345603
Provider Name (Legal Business Name): SARAH CONRAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 W 10TH ST
COLUMBUS OH
43212
US

IV. Provider business mailing address

1410 LINCOLN RD
COLUMBUS OH
43212-3276
US

V. Phone/Fax

Practice location:
  • Phone: 330-651-3076
  • Fax:
Mailing address:
  • Phone: 330-651-3076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0040240
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.394179
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: