Provider Demographics
NPI:1053055178
Name:FRICKE, SARAH ANN (BSN, ADN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:FRICKE
Suffix:
Gender:F
Credentials:BSN, ADN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 S TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5448
Mailing Address - Country:US
Mailing Address - Phone:970-252-5056
Mailing Address - Fax:970-964-2499
Practice Address - Street 1:1845 S TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5448
Practice Address - Country:US
Practice Address - Phone:970-252-5056
Practice Address - Fax:970-964-2499
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1672464163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse