Provider Demographics
NPI:1487390480
Name:RED, SARAH ASHLEY (MSN-PMHNP, BSN-RN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ASHLEY
Last Name:RED
Suffix:
Gender:F
Credentials:MSN-PMHNP, BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:PO BOX 1703
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-1703
Mailing Address - Country:US
Mailing Address - Phone:570-539-7234
Mailing Address - Fax:570-302-4238
Practice Address - Street 1:3154 MEMORIAL HWY STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-9203
Practice Address - Country:US
Practice Address - Phone:570-539-7234
Practice Address - Fax:570-324-4238
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH031313363LP0808X
PASP026838363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health