Provider Demographics
NPI:1992193759
Name:MERCER, SARAH C (STNA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:MERCER
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 1:129 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6009
Mailing Address - Country:US
Mailing Address - Phone:440-731-4476
Mailing Address - Fax:
Practice Address - Street 1:129 STANFORD AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6009
Practice Address - Country:US
Practice Address - Phone:440-731-4476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401683210814374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH401683210814OtherOHIO DEPARTMENT OF HEALTH