Healthcare Provider Details

I. General information

NPI: 1467951541
Provider Name (Legal Business Name): SARAH MACKENZIE MACDOUGALL APRN-CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH MACKENZIE UILENBERG

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-8700
  • Fax: 414-259-1522
Mailing address:
  • Phone: 414-805-8700
  • Fax: 414-259-1522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number119883
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC-APN.0101160-C-CRNA
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95093582
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number202343
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: