Healthcare Provider Details

I. General information

NPI: 1871037978
Provider Name (Legal Business Name): SARA ROBECK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA GEIER

II. Dates (important events)

Enumeration Date: 12/07/2016
Last Update Date: 06/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E 78TH ST STE 100
BLOOMINGTON MN
55420-1402
US

IV. Provider business mailing address

1900 SILVER LAKE RD NW
NEW BRIGHTON MN
55112-1786
US

V. Phone/Fax

Practice location:
  • Phone: 952-854-5034
  • Fax: 952-854-5363
Mailing address:
  • Phone: 651-379-1764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: