Provider Demographics
NPI:1093457632
Name:SPARTZ, SARA LUVERNE (CNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LUVERNE
Last Name:SPARTZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LUVERNE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1301 S CLIFF AVE STE 601
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1032
Mailing Address - Country:US
Mailing Address - Phone:605-322-6930
Mailing Address - Fax:605-322-6931
Practice Address - Street 1:1301 S CLIFF AVE STE 601
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1032
Practice Address - Country:US
Practice Address - Phone:605-322-6930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002377363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care