Provider Demographics
NPI:1437862174
Name:KLIMEK, SARA FE BANZUELA (MSN, RN, CNL, CEN)
Entity Type:Individual
Prefix:
First Name:SARA FE
Middle Name:BANZUELA
Last Name:KLIMEK
Suffix:
Gender:F
Credentials:MSN, RN, CNL, CEN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 3 BOX 3484
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96266-0035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:51ST MEDICAL GROUP, UNIT 2067, BLDG 777
Practice Address - Street 2:OSAN AIR BASE
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96266
Practice Address - Country:US
Practice Address - Phone:315-784-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79847163WC1500X
CA788385163WE0003X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA788385OtherCALIFORNIA BOARD OF REGISTERED NURSING