Healthcare Provider Details

I. General information

NPI: 1386560456
Provider Name (Legal Business Name): SARA LIEURANCE R.N., B.S.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 TRAVIS ST
LA CROSSE WI
54601-6835
US

IV. Provider business mailing address

2405 TRAVIS ST
LA CROSSE WI
54601-6835
US

V. Phone/Fax

Practice location:
  • Phone: 608-789-7948
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number138168-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: