Healthcare Provider Details

I. General information

NPI: 1619978764
Provider Name (Legal Business Name): SARA J ZIRBEL ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 N 9TH ST
MILWAUKEE WI
53233-1411
US

IV. Provider business mailing address

1027 N 9TH ST
MILWAUKEE WI
53233-1411
US

V. Phone/Fax

Practice location:
  • Phone: 414-765-0606
  • Fax:
Mailing address:
  • Phone: 414-765-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: