Provider Demographics
NPI:1770292518
Name:SHKLYAR, SARAH A
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:SHKLYAR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21700 INTERTECH DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-5197
Mailing Address - Country:US
Mailing Address - Phone:262-532-8300
Mailing Address - Fax:414-805-6864
Practice Address - Street 1:21700 INTERTECH DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-5197
Practice Address - Country:US
Practice Address - Phone:262-532-8300
Practice Address - Fax:414-805-6864
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13330363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care