Provider Demographics
NPI:1750514873
Name:LIBBY GLAPA, SARA ELIZABETH (APNP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:LIBBY GLAPA
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:E
Other - Last Name:GLAPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:W180N8085 TOWN HALL RD
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-3558
Mailing Address - Country:US
Mailing Address - Phone:262-251-1000
Mailing Address - Fax:262-253-5985
Practice Address - Street 1:W180N8085 TOWN HALL RD
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3518
Practice Address - Country:US
Practice Address - Phone:262-251-1000
Practice Address - Fax:262-253-5985
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3786363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1750514873Medicaid
WI736011517Medicare PIN