Healthcare Provider Details

I. General information

NPI: 1457162489
Provider Name (Legal Business Name): SARA A ZOGG LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 S COTTONWOOD ST
NORTH PLATTE NE
69101-5446
US

IV. Provider business mailing address

317 S COTTONWOOD ST
NORTH PLATTE NE
69101-5446
US

V. Phone/Fax

Practice location:
  • Phone: 308-660-1543
  • Fax:
Mailing address:
  • Phone: 308-660-1543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number20660
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: