Healthcare Provider Details
I. General information
NPI: 1528027695
Provider Name (Legal Business Name): ELIZABETH ANNE SARSLAND R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 03/18/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1112 BAKER AVE
AMERY WI
54001-5163
US
IV. Provider business mailing address
PO BOX 286
AMERY WI
54001-0286
US
V. Phone/Fax
- Phone: 715-268-6424
- Fax:
- Phone: 715-268-6424
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: