Healthcare Provider Details

I. General information

NPI: 1205467214
Provider Name (Legal Business Name): SARA E JONES APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA E LIPKA APRN-CNP

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 N HIGH ST
MOUNT ORAB OH
45154-6501
US

IV. Provider business mailing address

709 N HIGH ST
MOUNT ORAB OH
45154-6501
US

V. Phone/Fax

Practice location:
  • Phone: 513-242-7164
  • Fax: 937-444-6192
Mailing address:
  • Phone: 513-242-7164
  • Fax: 937-444-6192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026262
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: