Healthcare Provider Details

I. General information

NPI: 1942704713
Provider Name (Legal Business Name): SARAH RENE LIGGETT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5905 34TH AVE S
MINNEAPOLIS MN
55450-2900
US

IV. Provider business mailing address

5905 34TH AVE S
MINNEAPOLIS MN
55450-2900
US

V. Phone/Fax

Practice location:
  • Phone: 612-713-4600
  • Fax:
Mailing address:
  • Phone: 612-713-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number79940
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number79940
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: