Provider Demographics
NPI:1053498824
Name:DEUTSCH, SARAH RAE (CRNA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RAE
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:RAE
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:3000 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6132
Practice Address - Country:US
Practice Address - Phone:701-364-8000
Practice Address - Fax:701-364-8078
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDTO COME367500000X
NDR30400367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND14090Medicaid
ND2003850OtherMEDICA #
MN842983000Medicaid
NDHP75374OtherHEALTHPARTNERS #
ND00058880OtherLHS #
NDP00373802OtherRR MEDICARE
ND45-0345227-105OtherAMERICA'S PPO/ARAZ
ND1049433OtherPREFERRED ONE #
ND27768OtherNDBS #
ND667N4PEOtherMNBS #
NDHP75374OtherHEALTHPARTNERS #
ND2003850OtherMEDICA #