Healthcare Provider Details

I. General information

NPI: 1083918965
Provider Name (Legal Business Name): SCARLETT AMBER SARBAUGH AG-ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2011
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 SOUTHERN BLVD
KETTERING OH
45429-1221
US

IV. Provider business mailing address

5207 LITTLE TURTLE DR
SOUTH LEBANON OH
45065-8703
US

V. Phone/Fax

Practice location:
  • Phone: 937-294-3611
  • Fax: 937-294-9010
Mailing address:
  • Phone: 513-601-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0039297
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: