Provider Demographics
NPI:1528318870
Name:ARENS, SANDRA (MSN RN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:ARENS
Suffix:
Gender:F
Credentials:MSN RN
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:K
Other - Last Name:ARENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APNP, FNP-BC
Mailing Address - Street 1:905 S SCHARINE RD
Mailing Address - Street 2:
Mailing Address - City:AVALON
Mailing Address - State:WI
Mailing Address - Zip Code:53505-9528
Mailing Address - Country:US
Mailing Address - Phone:608-201-1110
Mailing Address - Fax:
Practice Address - Street 1:100 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-1732
Practice Address - Country:US
Practice Address - Phone:608-201-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI159880-030163W00000X
WI6012-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse