MEDICARE: SADIE VERSTEGEN

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	235Z00000X	Speech-Language Pathologist		WI

General Provider Information

NPI Number	:	1699432278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SADIE VERSTEGEN

Provider Business Mailing Address
First Line	:	W6127 LORNA LN
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54915-7465
Country	:	US
Telephone Number	:	920-585-9155
Fax Number	:

Provider Business Practice Location Address
First Line	:	W6127 LORNA LN
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54915-5491
Country	:	US
Telephone Number	:	920-840-3033
Fax Number	:

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

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	09/04/2025

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Directions to “ SADIE VERSTEGEN ” Practice Location

Language	Start Address	Practice Location

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