Provider Demographics
NPI:1831281989
Name:KRIETLOW, SARAH C (OD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:C
Last Name:KRIETLOW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 PIONEER TRL
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1167
Mailing Address - Country:US
Mailing Address - Phone:952-368-2325
Mailing Address - Fax:952-368-2328
Practice Address - Street 1:200 PIONEER TRL STE 108
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1169
Practice Address - Country:US
Practice Address - Phone:612-386-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2805152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2201475OtherMEDICA
MN736100900OtherMN CARE
MN847271028812OtherPREFERRED ONE
MN121037OtherEYEMED
MNHP35760OtherHEALTHPARTNERS
MN921871028812OtherPREFERRED ONE
MN131452OtherUCARE
MN147RICHOtherBLUE CROSS BLUE SHIELD
MN736100900OtherMN CARE
MN921871028812OtherPREFERRED ONE