Provider Demographics
NPI:1952000507
Name:SJOSTROM, SARAH KATHERINE (MSN, RN, ACNP-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHERINE
Last Name:SJOSTROM
Suffix:
Gender:F
Credentials:MSN, RN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 GREAT MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-4090
Mailing Address - Country:US
Mailing Address - Phone:781-234-9662
Mailing Address - Fax:
Practice Address - Street 1:7000 GREAT MEADOW RD
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-4090
Practice Address - Country:US
Practice Address - Phone:781-234-9662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN281099363LA2100X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care