Provider Demographics
NPI:1578904090
Name:BROWN, SARA RENAE (CNM)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:RENAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Mailing Address - Street 1:2603 WHITE BEAR AVE N
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5110
Mailing Address - Country:US
Mailing Address - Phone:651-209-8125
Mailing Address - Fax:651-348-8783
Practice Address - Street 1:1100 BERGSLIEN ST
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:WI
Practice Address - Zip Code:54002-2600
Practice Address - Country:US
Practice Address - Phone:715-684-1111
Practice Address - Fax:715-684-1119
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2023-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI148926367A00000X
MNR157232-0176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife