Provider Demographics
NPI:1154628568
Name:STIELE, SARA CAROLINE (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:CAROLINE
Last Name:STIELE
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 1:14167 GREEN VIEW CT
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-3041
Mailing Address - Country:US
Mailing Address - Phone:612-227-5876
Mailing Address - Fax:
Practice Address - Street 1:14167 GREEN VIEW CT
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-3041
Practice Address - Country:US
Practice Address - Phone:612-227-5876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 183669-7163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse