Provider Demographics
NPI:1215475520
Name:SCHIFSKY, SARAH BETH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:SCHIFSKY
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 1:5640 TURTLE LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126
Mailing Address - Country:US
Mailing Address - Phone:763-442-0532
Mailing Address - Fax:
Practice Address - Street 1:5640 TURTLE LAKE RD
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-4769
Practice Address - Country:US
Practice Address - Phone:763-442-0532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225080-3374J00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No374J00000XNursing Service Related ProvidersDoula