Provider Demographics
NPI:1619627643
Name:FREMSTAD, SARAH ANN (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:FREMSTAD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 STARWOOD AVE APT 11C
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1458
Mailing Address - Country:US
Mailing Address - Phone:605-924-0198
Mailing Address - Fax:
Practice Address - Street 1:715 N SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4451
Practice Address - Country:US
Practice Address - Phone:402-463-4521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant