Healthcare Provider Details

I. General information

NPI: 1316533144
Provider Name (Legal Business Name): SARAH DAWN MICHAEL LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4161 BRIDGEWATER PKWY
STOW OH
44224-6191
US

IV. Provider business mailing address

2500 STATE ROUTE 59
KENT OH
44240-7105
US

V. Phone/Fax

Practice location:
  • Phone: 330-865-4544
  • Fax: 330-865-4641
Mailing address:
  • Phone: 330-552-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number171869
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: