Provider Demographics
NPI:1740692987
Name:GOECKS, SARAH R (APNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:GOECKS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:R
Other - Last Name:SPOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-3528
Practice Address - Country:US
Practice Address - Phone:608-263-0946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI168438-30163W00000X
WI5837-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400156211Medicare Oscar/Certification
WIK400156207Medicare Oscar/Certification