Provider Demographics
NPI:1861626947
Name:PASSAGE, SARAH LYNNE (RN)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:LYNNE
Last Name:PASSAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 GRIDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3039
Mailing Address - Country:US
Mailing Address - Phone:414-517-1210
Mailing Address - Fax:414-777-1607
Practice Address - Street 1:8235 GRIDLEY AVE
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-3039
Practice Address - Country:US
Practice Address - Phone:414-517-1210
Practice Address - Fax:414-777-1607
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI165029030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health