| Doctor Name: | MISS SARAH STASIEWICZ |
| NPI Number: | 1043678683 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 371923 |
| Business Practice Address: | 6308 8th Ave Kenosha, WI - 531435031 |
| Business Phone Number: | 2626563590 |
| Business Fax Number: | 2626563591 |
| Mailing Address: | 6308 8th Ave, KENOSHA |
| State: | WI |
| Postal Code: | 531435031 |
| Phone Number: | 2626563313 |
| Fax Number: | 2626535850 |
| NPI Enumeration Date: | 02/09/2016 |
| NPI Last Update Date: | 03/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 371923 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |