MEDICARE: SARAH M SLIVON-VANCHENA APNP

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	364S00000X	Clinical Nurse Specialist	190388-30	WI
2	363L00000X	Nurse Practitioner	8473-33	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	190388-30	OTHER	WI	RN LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8473-33	OTHER	WI	APNP LICENSE

General Provider Information

NPI Number	:	1568954337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH M SLIVON-VANCHENA APNP

Provider Business Mailing Address
First Line	:	6308 8TH AVE
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53143-5031
Country	:	US
Telephone Number	:	262-656-5330
Fax Number	:	262-653-5346

Provider Business Practice Location Address
First Line	:	9697 SAINT CATHERINES DR STE 101
Second Line	:
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-2118
Country	:	US
Telephone Number	:	262-653-5330
Fax Number	:	262-653-5346

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

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	06/18/2026

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