Basic Information
| Provider Information | |||||||||
| NPI: | 1578626982 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEYSENBURG | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | CHRISTINE JENSEN | ||||||||
| NamePrefix: | |||||||||
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| Credential: | CPNP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | JENSEN | ||||||||
| OtherFirstName: | SARAH | ||||||||
| OtherMiddleName: | CHRISTINE | ||||||||
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| OtherCredential: | CPNP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5821 IRVING AVE S | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554192038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105979965 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1875 WOODWINDS DR | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551252298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512326700 | ||||||||
| FaxNumber: | 6512326711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | R147961-4 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.