Healthcare Provider Details

I. General information

NPI: 1568954337
Provider Name (Legal Business Name): SARAH M SLIVON-VANCHENA APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9697 SAINT CATHERINES DR STE 101
PLEASANT PRAIRIE WI
53158-2118
US

IV. Provider business mailing address

6308 8TH AVE
KENOSHA WI
53143-5031
US

V. Phone/Fax

Practice location:
  • Phone: 262-653-5330
  • Fax: 262-653-5346
Mailing address:
  • Phone: 262-656-5330
  • Fax: 262-653-5346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number190388-30
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8473-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: