Healthcare Provider Details

I. General information

NPI: 1063766921
Provider Name (Legal Business Name): CYNTHIA LEE SAARIO APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 W LOOMIS RD SUITE 300
GREENFIELD WI
53221-2057
US

IV. Provider business mailing address

4131 W LOOMIS RD SUITE 300
GREENFIELD WI
53221-2057
US

V. Phone/Fax

Practice location:
  • Phone: 414-325-7246
  • Fax: 414-325-3770
Mailing address:
  • Phone: 414-325-7246
  • Fax: 414-325-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5124-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: