Provider Demographics
NPI:1518360619
Name:HOLTHE, SARAH KATHLEEN (APNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHLEEN
Last Name:HOLTHE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:KATHLEEN
Other - Last Name:STADELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:804 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-9145
Mailing Address - Country:US
Mailing Address - Phone:608-220-2874
Mailing Address - Fax:
Practice Address - Street 1:804 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636-9145
Practice Address - Country:US
Practice Address - Phone:608-220-2874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5924363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology