MEDICARE: SARAH BLAIR GATTIS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	528596	OH

General Provider Information

NPI Number	:	1447076567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH BLAIR GATTIS RN

Provider Business Mailing Address
First Line	:	710 VILLAGE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2848
Country	:	US
Telephone Number	:	912-661-4867
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 VILLAGE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2848
Country	:	US
Telephone Number	:	912-661-4867
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2024
Last Update Date	:	11/25/2024

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