Healthcare Provider Details

I. General information

NPI: 1316876899
Provider Name (Legal Business Name): SARAH KADOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2902 LINDBERGH DR
MANITOWOC WI
54220-3626
US

IV. Provider business mailing address

2902 LINDBERGH DR
MANITOWOC WI
54220-3626
US

V. Phone/Fax

Practice location:
  • Phone: 920-686-4777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number135500-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: