Provider Demographics
NPI:1336737568
Name:ZEMANOVIC, SARA (CAA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ZEMANOVIC
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7930 HARWOOD AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-2570
Mailing Address - Country:US
Mailing Address - Phone:414-550-0092
Mailing Address - Fax:
Practice Address - Street 1:W180N8085 TOWN HALL RD
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3518
Practice Address - Country:US
Practice Address - Phone:262-257-5100
Practice Address - Fax:262-518-5052
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI177-17367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant