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General NPI Number Information
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NPI Number | 1528313012
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Entity Type | Individual
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Provider Name | SARA M HAVERTY CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/20/2012
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 2951 MAPLE AVE
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City | ZANESVILLE
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State | OH
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Zip | 43701
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Country | US
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Telephone | 740-454-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 67721 ROBIN ST
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City | BELMONT
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State | OH
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Zip | 43718
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Country | US
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Telephone | 614-657-4065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 312504
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 13843
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN.CRNA.13843
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License Number State | OH
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