Provider Demographics
NPI:1821214057
Name:LUNDELL, SARAH R
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:LUNDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-2026
Mailing Address - Country:US
Mailing Address - Phone:712-263-3172
Mailing Address - Fax:712-263-5756
Practice Address - Street 1:20 N 14TH ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-2026
Practice Address - Country:US
Practice Address - Phone:712-263-3172
Practice Address - Fax:712-263-5756
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator