Healthcare Provider Details

I. General information

NPI: 1306756424
Provider Name (Legal Business Name): SARA FELLAND RN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 CARMICHAEL RD
HUDSON WI
54016-7711
US

IV. Provider business mailing address

1350 CARMICHAEL RD
HUDSON WI
54016-7711
US

V. Phone/Fax

Practice location:
  • Phone: 715-377-3710
  • Fax: 715-377-3821
Mailing address:
  • Phone: 715-377-3710
  • Fax: 715-377-3821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number144938-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: