Healthcare Provider Details

I. General information

NPI: 1225364011
Provider Name (Legal Business Name): SARA ELISABETH KING CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 W HIGH AVE
NEW PHILADELPHIA OH
44663-2071
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-308-5432
  • Fax: 330-339-5912
Mailing address:
  • Phone: 330-308-5432
  • Fax: 330-339-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA.04159-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: