Provider Demographics
NPI:1598774200
Name:BENO-CHAMBERS, SARA JANE (APNP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:JANE
Last Name:BENO-CHAMBERS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:414-647-6326
Mailing Address - Fax:414-671-8860
Practice Address - Street 1:2845 GREENBRIER RD
Practice Address - Street 2:#140
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54308-8900
Practice Address - Country:US
Practice Address - Phone:920-288-8100
Practice Address - Fax:920-288-8153
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2106-033363L00000X
WI132428-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse