Provider Demographics
NPI:1467115121
Name:HART, SARAH MUDD (RN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MUDD
Last Name:HART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:MUDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4820 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1043
Mailing Address - Country:US
Mailing Address - Phone:216-429-5884
Mailing Address - Fax:216-429-5708
Practice Address - Street 1:4840 E 71ST ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-1043
Practice Address - Country:US
Practice Address - Phone:216-429-5884
Practice Address - Fax:216-429-5706
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH439081163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool