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General NPI Number Information
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NPI Number | 1912375452
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Entity Type | Individual
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Provider Name | SARA EHRENSBERGER PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 2055 HOSPITAL DR STE 345
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City | BATAVIA
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State | OH
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Zip | 45103-1978
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Country | US
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Telephone | 513-732-9570
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 FAR HILLS AVE
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City | DAYTON
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State | OH
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Zip | 45429-2381
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Country | US
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Telephone | 937-433-7536
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 52786
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.008768RX
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License Number State | OH
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