Healthcare Provider Details

I. General information

NPI: 1790690006
Provider Name (Legal Business Name): SARA L BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 MAGDALENA DR
UNION OH
45322-9780
US

IV. Provider business mailing address

104 MAGDALENA DR
UNION OH
45322-9780
US

V. Phone/Fax

Practice location:
  • Phone: 937-836-6061
  • Fax:
Mailing address:
  • Phone: 513-267-3244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN476095
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: