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General NPI Number Information
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NPI Number | 1912370545
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Entity Type | Individual
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Provider Name | SARAH H WILSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 4421 EASTGATE BLVD STE 300
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City | CINCINNATI
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State | OH
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Zip | 45245-4501
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Country | US
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Telephone | 513-752-8000
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Fax | 513-752-1078
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Provider Business Mailing Address
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Address Line | 800 ROSE ST MN602
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City | LEXINGTON
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State | KY
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Zip | 40536-0294
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Country | US
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Telephone | 859-323-6047
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Fax | 859-257-3873
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 50005372RX
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | TC441
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License Number State | KY
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