Healthcare Provider Details

I. General information

NPI: 1215874656
Provider Name (Legal Business Name): ELIZABETH SAGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 RANDOLPH AVE
SAINT PAUL MN
55105-1750
US

IV. Provider business mailing address

2004 RANDOLPH AVE
SAINT PAUL MN
55105-1750
US

V. Phone/Fax

Practice location:
  • Phone: 651-690-7827
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15729
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: