Doctor Name: | MS. SARA MARIE GUDENKAUF |
NPI Number: | 1285942359 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 111168 |
Business Practice Address: | 5409 Avenue O Fort Madison, IA - 526279601 |
Business Phone Number: | 3193762134 |
Business Fax Number: | 3193762188 |
Mailing Address: | 5409 Avenue O, FORT MADISON |
State: | IA |
Postal Code: | 526279601 |
Phone Number: | 3193762134 |
Fax Number: | 3193762188 |
NPI Enumeration Date: | 09/22/2010 |
NPI Last Update Date: | 10/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LC0200X |
License Number: | 111168 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NE |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Critical Care Medicine |
Taxonomy Definition: |