MEDICARE: SARAH KATHERINE NYGREN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1124504576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH KATHERINE NYGREN

Provider Business Mailing Address
First Line	:	3714 N 97TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-2629
Country	:	US
Telephone Number	:	414-581-4902
Fax Number	:

Provider Business Practice Location Address
First Line	:	3732 W WISCONSIN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-3166
Country	:	US
Telephone Number	:	414-290-0446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2018
Last Update Date	:	08/25/2025

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