Provider Demographics
NPI:1689464489
Name:KAUL, SANDRA JEAN (RN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEAN
Last Name:KAUL
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:JEAN
Other - Last Name:ZIMMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:272 E MONTELLO ST
Mailing Address - Street 2:
Mailing Address - City:MONTELLO
Mailing Address - State:WI
Mailing Address - Zip Code:53949-9701
Mailing Address - Country:US
Mailing Address - Phone:608-697-9642
Mailing Address - Fax:608-697-9642
Practice Address - Street 1:272 E MONTELLO ST
Practice Address - Street 2:
Practice Address - City:MONTELLO
Practice Address - State:WI
Practice Address - Zip Code:53949-9701
Practice Address - Country:US
Practice Address - Phone:608-697-9642
Practice Address - Fax:608-697-9642
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI175661-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse