Provider Demographics
NPI:1922833789
Name:KELLEY, SARAH MARGARET
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARGARET
Last Name:KELLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 W 155TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-2027
Mailing Address - Country:US
Mailing Address - Phone:216-496-9091
Mailing Address - Fax:
Practice Address - Street 1:26522 NORMANDY RD
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2316
Practice Address - Country:US
Practice Address - Phone:440-840-3095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide