Healthcare Provider Details

I. General information

NPI: 1336115815
Provider Name (Legal Business Name): SARA L STROM AAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 22ND AVE
MONROE WI
53566-1569
US

IV. Provider business mailing address

111 ACKER CT
VERONA WI
53593-2251
US

V. Phone/Fax

Practice location:
  • Phone: 608-324-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number3
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: