Provider Demographics
NPI:1134000573
Name:SANSA, ANGE PRYCIA
Entity type:Individual
Prefix:
First Name:ANGE PRYCIA
Middle Name:
Last Name:SANSA
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 1:3859 WOODRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7638
Mailing Address - Country:US
Mailing Address - Phone:513-499-6601
Mailing Address - Fax:
Practice Address - Street 1:3859 WOODRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7638
Practice Address - Country:US
Practice Address - Phone:513-499-6601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide