Provider Demographics
NPI:1639581101
Name:ROMEO, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ROMEO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 6TH ST SW APT 103
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-3207
Mailing Address - Country:US
Mailing Address - Phone:507-993-0936
Mailing Address - Fax:
Practice Address - Street 1:428 6TH ST SW APT 103
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-3207
Practice Address - Country:US
Practice Address - Phone:507-993-0936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN212588-6163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse