Healthcare Provider Details

I. General information

NPI: 1124255831
Provider Name (Legal Business Name): SARAH J FROGGE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2009
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

10000 W INNOVATION DR THIRD FLOOR
MILWAUKEE WI
53226-4837
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-5400
  • Fax: 414-955-0115
Mailing address:
  • Phone: 414-456-5006
  • Fax: 414-456-6259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number157252
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: