Individual
SARA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
900 N 92ND ST, MILWAUKEE, WI 53226-1202
(414) 585-1000
Mailing address
400 W RIVER WOODS PKWY, GLENDALE, WI 53212-1060
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
308400
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
11377
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073181160
—
WI
Enumeration date
06/15/2021
Last updated
03/22/2025
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