Provider Demographics
NPI:1316219124
Name:CLASON, SABRINA (RN)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:CLASON
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:N5337 HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54615-8503
Mailing Address - Country:US
Mailing Address - Phone:715-533-0730
Mailing Address - Fax:
Practice Address - Street 1:1239 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-1907
Practice Address - Country:US
Practice Address - Phone:715-284-9775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI175931-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse