Provider Demographics
NPI:1699296400
Name:WELLS, SARAH NICHOLE (STNA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NICHOLE
Last Name:WELLS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 HOSTETLER RD APT 1
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-1085
Mailing Address - Country:US
Mailing Address - Phone:330-641-1948
Mailing Address - Fax:
Practice Address - Street 1:1048 HOSTETLER RD APT 1
Practice Address - Street 2:
Practice Address - City:ORRVILLE
Practice Address - State:OH
Practice Address - Zip Code:44667-1085
Practice Address - Country:US
Practice Address - Phone:330-641-1948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSN719316347C00000X
OH401737870415372500000X, 372600000X, 376J00000X, 374U00000X, 376K00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No347C00000XTransportation ServicesPrivate Vehicle
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide