1992242648 NPI number — MRS. SARAH LEEVIE MARSTEIN RN, MSN, CPNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992242648 NPI number — MRS. SARAH LEEVIE MARSTEIN RN, MSN, CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARSTEIN
Provider First Name:
SARAH
Provider Middle Name:
LEEVIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUDNITSKI
Provider Other First Name:
SARAH
Provider Other Middle Name:
LEEVIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992242648
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 2ND ST S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SARTELL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56377
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-281-3339
Provider Business Mailing Address Fax Number:
320-200-7505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 2ND ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARTELL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-281-3339
Provider Business Practice Location Address Fax Number:
320-200-7505
Provider Enumeration Date:
01/19/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  CNP 4972 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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