Provider Demographics
NPI:1144564519
Name:GIRVAN, SARAH E (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:GIRVAN
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 1:4102 N WILSON DR APT 1
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-1869
Mailing Address - Country:US
Mailing Address - Phone:425-328-9270
Mailing Address - Fax:
Practice Address - Street 1:4102 N WILSON DR APT 1
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-1869
Practice Address - Country:US
Practice Address - Phone:425-328-9270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-25
Last Update Date:2012-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI191767-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse