Provider Demographics
NPI:1831121680
Name:MUTSCHLECNER, SARAH C (APNP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:C
Last Name:MUTSCHLECNER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARGARET
Other - Last Name:MUTSCHLECNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:611 N SAINT JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-1832
Mailing Address - Country:US
Mailing Address - Phone:352-265-0301
Mailing Address - Fax:715-387-5134
Practice Address - Street 1:611 N SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-1832
Practice Address - Country:US
Practice Address - Phone:715-387-5143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9192841363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305172200Medicaid
FLE8928Medicare ID - Type Unspecified