Provider Demographics
NPI:1154199032
Name:ODEN, SARAH LAVETTE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LAVETTE
Last Name:ODEN
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 1:6493 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1201
Mailing Address - Country:US
Mailing Address - Phone:419-537-3994
Mailing Address - Fax:
Practice Address - Street 1:6493 GARDEN RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1201
Practice Address - Country:US
Practice Address - Phone:419-537-3994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker