Healthcare Provider Details

I. General information

NPI: 1740713239
Provider Name (Legal Business Name): SARA FLATEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA M JENSON

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 DEMERS AVE STE 303
GRAND FORKS ND
58201-4599
US

IV. Provider business mailing address

640 2ND ST S
MIDDLE RIVER MN
56737-4020
US

V. Phone/Fax

Practice location:
  • Phone: 701-757-0292
  • Fax:
Mailing address:
  • Phone: 218-791-6748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4585
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: