Healthcare Provider Details

I. General information

NPI: 1881467678
Provider Name (Legal Business Name): SARAH PENNEBAKER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6275 EMERALD PKWY
DUBLIN OH
43016-3241
US

IV. Provider business mailing address

6275 EMERALD PKWY
DUBLIN OH
43016-3241
US

V. Phone/Fax

Practice location:
  • Phone: 614-792-5698
  • Fax: 614-792-5699
Mailing address:
  • Phone: 614-792-5698
  • Fax: 614-792-5699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008465RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: