Provider Demographics
NPI:1447076567
Name:GATTIS, SARAH BLAIR (RN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BLAIR
Last Name:GATTIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2848
Mailing Address - Country:US
Mailing Address - Phone:912-661-4867
Mailing Address - Fax:
Practice Address - Street 1:710 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2848
Practice Address - Country:US
Practice Address - Phone:912-661-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH528596163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health