Provider Demographics
NPI:1558323352
Name:BOLSTAD, SARAH ANNE (PAC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANNE
Last Name:BOLSTAD
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:920 E 28TH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1163
Mailing Address - Country:US
Mailing Address - Phone:952-567-7400
Mailing Address - Fax:952-852-2356
Practice Address - Street 1:920 E 28TH ST STE 700
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1163
Practice Address - Country:US
Practice Address - Phone:952-567-7400
Practice Address - Fax:952-852-2356
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2021-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN9617363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical