Healthcare Provider Details

I. General information

NPI: 1558795252
Provider Name (Legal Business Name): SARA LYNN WOLFE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA LYNN BERDING ARNP

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S PIERCE AVE STE 150
MASON CITY IA
50401-2711
US

IV. Provider business mailing address

621 S ILLINOIS AVE SUITE 103
MASON CITY IA
50401-5489
US

V. Phone/Fax

Practice location:
  • Phone: 641-494-5000
  • Fax: 641-494-5028
Mailing address:
  • Phone: 641-428-3041
  • Fax: 641-428-3059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberH109065
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: