Provider Demographics
NPI:1366722118
Name:FRITZ, SARAH S
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:S
Last Name:FRITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:S
Other - Last Name:KEPPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1222 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3171
Mailing Address - Country:US
Mailing Address - Phone:920-457-6800
Mailing Address - Fax:920-457-3772
Practice Address - Street 1:1222 N 23RD ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3171
Practice Address - Country:US
Practice Address - Phone:920-457-6800
Practice Address - Fax:920-457-3772
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4520-033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily