Provider Demographics
NPI:1093252819
Name:HOLBROOK, SARAH (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7989 ARPIN RICHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ARPIN
Mailing Address - State:WI
Mailing Address - Zip Code:54410-9520
Mailing Address - Country:US
Mailing Address - Phone:715-897-1101
Mailing Address - Fax:
Practice Address - Street 1:7989 ARPIN RICHFIELD RD
Practice Address - Street 2:
Practice Address - City:ARPIN
Practice Address - State:WI
Practice Address - Zip Code:54410-9520
Practice Address - Country:US
Practice Address - Phone:715-897-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148067163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse