Healthcare Provider Details
I. General information
NPI: 1497265664
Provider Name (Legal Business Name): SARAH PORTERFIELD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2017
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6350 W 143RD ST STE 102
SAVAGE MN
55378-2890
US
IV. Provider business mailing address
2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US
V. Phone/Fax
- Phone: 952-428-1000
- Fax: 952-428-0499
- Phone: 952-428-1000
- Fax: 952-428-0499
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 15150 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: