Provider Demographics
NPI:1124410923
Name:STINEMATES, SARAH JANE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JANE
Last Name:STINEMATES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:STINEMATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:441 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:OMRO
Mailing Address - State:WI
Mailing Address - Zip Code:54963-1148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:441 WILLOW ST
Practice Address - Street 2:
Practice Address - City:OMRO
Practice Address - State:WI
Practice Address - Zip Code:54963-1148
Practice Address - Country:US
Practice Address - Phone:920-642-0685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33746-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse