Provider Demographics
NPI:1861165672
Name:TRIPLETT, SAKOTA DAWN
Entity type:Individual
Prefix:
First Name:SAKOTA
Middle Name:DAWN
Last Name:TRIPLETT
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 1:2333 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-5649
Mailing Address - Country:US
Mailing Address - Phone:414-539-6057
Mailing Address - Fax:414-539-6037
Practice Address - Street 1:2333 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-5649
Practice Address - Country:US
Practice Address - Phone:414-539-6057
Practice Address - Fax:414-539-6037
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0018442310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility