Healthcare Provider Details

I. General information

NPI: 1467162016
Provider Name (Legal Business Name): SARAH RAE ZARENANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH RAE CHERNOHORSKY

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1366 E SUMNER ST # 1002
HARTFORD WI
53027-1614
US

IV. Provider business mailing address

5750 JOHNSTON ST STE 205
LAFAYETTE LA
70503-5345
US

V. Phone/Fax

Practice location:
  • Phone: 337-991-9276
  • Fax: 337-943-0846
Mailing address:
  • Phone: 337-991-9276
  • Fax: 337-943-0846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021101461
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13589-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: