Provider Demographics
NPI:1043551773
Name:FEIERABEND, SARAH LYN (DNP, CNM)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYN
Last Name:FEIERABEND
Suffix:
Gender:F
Credentials:DNP, CNM
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:MINDEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1527 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2537
Mailing Address - Country:US
Mailing Address - Phone:320-762-0399
Mailing Address - Fax:320-762-6828
Practice Address - Street 1:1527 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2537
Practice Address - Country:US
Practice Address - Phone:320-762-0399
Practice Address - Fax:320-762-6828
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN235068-0163W00000X
MNCNM0309367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse