MEDICARE: SARAH A ESKOFSKI 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	363L00000X	Nurse Practitioner	4626	WI

General Provider Information

NPI Number	:	1790069920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH A ESKOFSKI APNP

Provider Business Mailing Address
First Line	:	PO BOX 19070
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54307-9070
Country	:	US
Telephone Number	:	920-496-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	419 S WASHINGTON ST
Second Line	:
City	:	COMBINED LOCKS
State	:	WI
Zip	:	54113-1049
Country	:	US
Telephone Number	:	920-496-4700
Fax Number	:

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

Provider Enumeration Date	:	10/06/2011
Last Update Date	:	08/04/2022

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