Healthcare Provider Details

I. General information

NPI: 1457695405
Provider Name (Legal Business Name): SARA C PETEE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA STONER FNP

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2277 MICHIGAN ST
SIDNEY OH
45365-9077
US

IV. Provider business mailing address

1430 OAK CT STE 100
BEAVERCREEK OH
45430-1064
US

V. Phone/Fax

Practice location:
  • Phone: 937-492-1961
  • Fax:
Mailing address:
  • Phone: 937-404-1101
  • Fax: 937-404-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.13999
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: