Provider Demographics
NPI:1114794526
Name:SAUER, BROOKE ANN
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANN
Last Name:SAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13421 HEMLOCK LN N
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:55327-9697
Mailing Address - Country:US
Mailing Address - Phone:651-757-7703
Mailing Address - Fax:
Practice Address - Street 1:1833 3RD AVE
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2424
Practice Address - Country:US
Practice Address - Phone:612-924-3807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program