Healthcare Provider Details

I. General information

NPI: 1639500853
Provider Name (Legal Business Name): SARA RAMIREZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2013
Last Update Date: 12/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

953 S SOUTH ST
WILMINGTON OH
45177-2921
US

IV. Provider business mailing address

975 KINGSVIEW DR
LEBANON OH
45036-9562
US

V. Phone/Fax

Practice location:
  • Phone: 937-383-4441
  • Fax: 937-383-2916
Mailing address:
  • Phone: 513-228-7800
  • Fax: 513-228-7848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-395467
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: