Provider Demographics
NPI:1295092369
Name:VOSEN, SARAH (LAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:VOSEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7480 JEANNE DR
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-3012
Mailing Address - Country:US
Mailing Address - Phone:310-883-8196
Mailing Address - Fax:
Practice Address - Street 1:3550 LEXINGTON AVE N
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-8075
Practice Address - Country:US
Practice Address - Phone:612-547-9477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12691171100000X
MN1576171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist