MEDICARE: SARAH MARY-PAYNE OSWALD RN

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	363LP2300X	Primary Care Nurse Practitioner	R160820-7	MN
2	163WH0200X	Home Health Registered Nurse	R160820-7	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205088325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MARY-PAYNE OSWALD RN

Provider Business Mailing Address
First Line	:	7200 HUDSON BLVD N STE 230
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-7098
Country	:	US
Telephone Number	:	651-735-3656
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 HUDSON BLVD N STE 200
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-7098
Country	:	US
Telephone Number	:	651-735-3656
Fax Number	:

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

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	12/07/2022

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