Provider Demographics
NPI:1194056630
Name:ELSBECKER, SARA ANN (RN CPNP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:ELSBECKER
Suffix:
Gender:F
Credentials:RN CPNP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:A
Other - Last Name:SCHLORHOLTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN CPNP
Mailing Address - Street 1:420 DELAWARE ST SE MMC 730
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-5275
Mailing Address - Fax:612-626-2993
Practice Address - Street 1:2512 S 7TH ST
Practice Address - Street 2:2512 BUILDING, 3RD FLOOR
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1404
Practice Address - Country:US
Practice Address - Phone:612-365-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 178485-9163W00000X
MN20091559363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse