Provider Demographics
NPI:1063085173
Name:SCHELLHARDT, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SCHELLHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SCOTTIE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-4122
Mailing Address - Country:US
Mailing Address - Phone:240-372-5362
Mailing Address - Fax:
Practice Address - Street 1:108 SCOTTIE DR
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-4122
Practice Address - Country:US
Practice Address - Phone:240-372-5362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant