Provider Demographics
NPI:1205088325
Name:OSWALD, SARAH MARY-PAYNE (RN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARY-PAYNE
Last Name:OSWALD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:7200 HUDSON BLVD N STE 230
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-7098
Mailing Address - Country:US
Mailing Address - Phone:651-735-3656
Mailing Address - Fax:
Practice Address - Street 1:7200 HUDSON BLVD N STE 200
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-7098
Practice Address - Country:US
Practice Address - Phone:651-735-3656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR160820-7363LP2300X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7777777Medicaid