Provider Demographics
NPI:1144733742
Name:GILLE, SARAH (CST/CSFA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GILLE
Suffix:
Gender:F
Credentials:CST/CSFA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CST/CSFA
Mailing Address - Street 1:2400 PINE RIDGE BLVD.
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7803
Mailing Address - Country:US
Mailing Address - Phone:715-847-2022
Mailing Address - Fax:715-847-2775
Practice Address - Street 1:2400 PINE RIDGE BLVD.
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7803
Practice Address - Country:US
Practice Address - Phone:715-847-2022
Practice Address - Fax:715-847-2775
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant