Provider Demographics
NPI:1740465111
Name:WAWRZYNIAK, SARAH E (APNP)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:WAWRZYNIAK
Suffix:
Gender:
Credentials:APNP
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:HEATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:5002 FOX KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:COLGATE
Mailing Address - State:WI
Mailing Address - Zip Code:53017-9127
Mailing Address - Country:US
Mailing Address - Phone:622-648-4142
Mailing Address - Fax:866-766-0829
Practice Address - Street 1:5002 FOX KNOLL LN
Practice Address - Street 2:
Practice Address - City:COLGATE
Practice Address - State:WI
Practice Address - Zip Code:53017-9127
Practice Address - Country:US
Practice Address - Phone:622-648-4142
Practice Address - Fax:866-766-0829
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3214-33363LP0808X
WI149357363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1740465111Medicaid
WI73601 1913Medicare PIN