Provider Demographics
NPI:1457240095
Name:BJORNSTAD, SANDRA LEA (RN, OMS, WCC, DWC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEA
Last Name:BJORNSTAD
Suffix:
Gender:F
Credentials:RN, OMS, WCC, DWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3868 REDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-5841
Mailing Address - Country:US
Mailing Address - Phone:608-754-9216
Mailing Address - Fax:
Practice Address - Street 1:11101 N SHERMAN RD
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:WI
Practice Address - Zip Code:53534-9002
Practice Address - Country:US
Practice Address - Phone:608-884-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI115364-30163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care