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NPI Code Detail

MEDICARE: SARA MEZZANO RN

MEDICARE: SARA MEZZANO RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA0400XAddiction (Substance Use Disorder) Registered NurseR2220370MI

General Provider Information

NPI Number : 1982061768
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA MEZZANO RN
Provider Business Mailing Address
First Line : 680 STEWART AVE
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-4117
Country : US
Telephone Number : 651-292-2477
Fax Number :
Provider Business Practice Location Address
First Line : 680 STEWART AVE
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-4117
Country : US
Telephone Number : 651-292-2477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2016
Last Update Date : 01/25/2016

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