Provider Demographics
NPI:1699173302
Name:RABE, SARAH E (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:RABE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-655-2755
Mailing Address - Fax:859-655-2755
Practice Address - Street 1:375 WEAVER RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2998
Practice Address - Country:US
Practice Address - Phone:859-655-2755
Practice Address - Fax:859-655-2755
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPA2212363AM0700X
KYPA2165363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0169Medicare PIN