Provider Demographics
NPI:1023367489
Name:ERDAHL, SARA ANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ANNE
Last Name:ERDAHL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:ANNE
Other - Last Name:KOBERSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1980 LONE OAK CIR E
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-5036
Mailing Address - Country:US
Mailing Address - Phone:262-617-0481
Mailing Address - Fax:
Practice Address - Street 1:N16W24131 RIVERWOOD DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1106
Practice Address - Country:US
Practice Address - Phone:262-696-5685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16791-401835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist