Provider Demographics
NPI:1154864965
Name:SARAUER, NICOLE ANNE (CNS)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:ANNE
Last Name:SARAUER
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 DAHLBERG DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4840
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5651
Practice Address - Street 1:1701 CURVE CREST BLVD W
Practice Address - Street 2:SUITE 104
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6044
Practice Address - Country:US
Practice Address - Phone:651-351-2680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNS 0330364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology