Provider Demographics
NPI:1730623091
Name:LAUBE, SARAH S
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:S
Last Name:LAUBE
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-655-8910
Mailing Address - Fax:859-655-8911
Practice Address - Street 1:1500 JAMES SIMPSON JR. WAY, STE 301
Practice Address - Street 2:ST. ELIZABETH PHYSICIANS REGIONAL DIABETES CENTER
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011
Practice Address - Country:US
Practice Address - Phone:859-655-8910
Practice Address - Fax:859-655-8911
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD6914133V00000X
KY171033133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered