Healthcare Provider Details

I. General information

NPI: 1154942100
Provider Name (Legal Business Name): SARAH MAINZINGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 N MCCORD RD
TOLEDO OH
43615-1753
US

IV. Provider business mailing address

23481 WAGAR CT
BROWNSTOWN MI
48183-2149
US

V. Phone/Fax

Practice location:
  • Phone: 419-842-3000
  • Fax:
Mailing address:
  • Phone: 734-915-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704320587
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0027786
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN376119
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.376119
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: