Provider Demographics
NPI:1669681425
Name:BJERKE, SARA ELIZABETH (ATC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:BJERKE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4629 LOAMY HILLS PL
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-7933
Mailing Address - Country:US
Mailing Address - Phone:218-791-3289
Mailing Address - Fax:
Practice Address - Street 1:1301 N COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-6098
Practice Address - Country:US
Practice Address - Phone:701-777-3883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND172-972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer