Provider Demographics
NPI:1174328967
Name:DILLMAN, SARA M (APRN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 LEMON TREE LN
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2173
Mailing Address - Country:US
Mailing Address - Phone:513-430-4110
Mailing Address - Fax:
Practice Address - Street 1:1222 LEMON TREE LN
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2173
Practice Address - Country:US
Practice Address - Phone:513-430-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-15
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4035077363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health