Healthcare Provider Details

I. General information

NPI: 1912940420
Provider Name (Legal Business Name): SARAJEAN M. HERRMANN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2321 STOUT RD
MENOMONIE WI
54751-7003
US

IV. Provider business mailing address

200 1ST ST SW
ROCHESTER MN
55905-0001
US

V. Phone/Fax

Practice location:
  • Phone: 715-235-5531
  • Fax: 715-233-7645
Mailing address:
  • Phone: 715-838-5222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42640-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: