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General NPI Number Information
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NPI Number | 1124142849
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Entity Type | Individual
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Provider Name | SARAH ANNE STODDARD MS, RN, CNP
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 14790 119TH ST N
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City | STILLWATER
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State | MN
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Zip | 55082-8906
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Country | US
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Telephone | 651-439-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 14082 TOLEDO CT
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City | SAVAGE
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State | MN
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Zip | 55378-1972
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Country | US
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Telephone | 612-481-2664
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R 128860-1
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R 128860-1
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 19990640
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License Number State | MN
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