Healthcare Provider Details

I. General information

NPI: 1013274356
Provider Name (Legal Business Name): SANDRALEE S QUADE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 S KOELLER ST
OSHKOSH WI
54902-6186
US

IV. Provider business mailing address

1855 S KOELLER ST
OSHKOSH WI
54902-6186
US

V. Phone/Fax

Practice location:
  • Phone: 920-223-7100
  • Fax:
Mailing address:
  • Phone: 920-223-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4819
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: