Provider Demographics
NPI:1871060582
Name:WOODS, SARAH NICOLE (MSN-ED, RN-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLE
Last Name:WOODS
Suffix:
Gender:F
Credentials:MSN-ED, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENBUD DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:OH
Mailing Address - Zip Code:45122-9419
Mailing Address - Country:US
Mailing Address - Phone:513-545-5021
Mailing Address - Fax:
Practice Address - Street 1:6201 GREENBUD DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:OH
Practice Address - Zip Code:45122-9419
Practice Address - Country:US
Practice Address - Phone:513-545-5021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.398036163WP0808X
372500000X, 372600000X, 376J00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0322872Medicaid