Provider Demographics
NPI:1437465473
Name:BRUMBERG, SARAH MARIE (RN, CNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:BRUMBERG
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:BRUMBERG
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNP
Mailing Address - Street 1:814 SOUTH 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415
Mailing Address - Country:US
Mailing Address - Phone:612-888-9792
Mailing Address - Fax:
Practice Address - Street 1:814 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415
Practice Address - Country:US
Practice Address - Phone:612-888-9792
Practice Address - Fax:612-888-9762
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN447363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner