Healthcare Provider Details

I. General information

NPI: 1689210486
Provider Name (Legal Business Name): SARAH M KANE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 HAMLINE AVE S
SAINT PAUL MN
55116-2238
US

IV. Provider business mailing address

701 HAMLINE AVE S
SAINT PAUL MN
55116-2238
US

V. Phone/Fax

Practice location:
  • Phone: 651-503-9719
  • Fax:
Mailing address:
  • Phone: 651-503-9719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13593
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: