Provider Demographics
NPI:1942672647
Name:LEMMON, SARA LOUISE (PA-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LOUISE
Last Name:LEMMON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:28871 CENTER RIDGE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5271
Mailing Address - Country:US
Mailing Address - Phone:440-250-2130
Mailing Address - Fax:440-250-2140
Practice Address - Street 1:7601 OSLER DR
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7700
Practice Address - Country:US
Practice Address - Phone:330-631-6695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH004452363A00000X
MD363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant