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Individual

MS. SARAH M FUGLEBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12499 UNIVERSITY AVE, STE 200, CLIVE, IA 50325-8281
(515) 418-9960
(515) 418-9107
Mailing address
12499 UNIVERSITY AVE, STE 200, CLIVE, IA 50325-8281
(515) 418-9960
(515) 418-9107

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
254
NE
237600000X
Audiologist-Hearing Aid Fitter
081
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100250037-00
NE
05
100250041-00
NE
05
100251703-00
NE
05
100251704-00
NE
05
100252023-00
NE
05
100252024-00
NE
05
10025369300
NE
05
10025369400
NE
05
1723312
IA
01
36845
BCBS
NE
05
4723312
IA
05
5723312
IA
05
6723312
IA
05
7723312
IA
Enumeration date
01/05/2007
Last updated
12/18/2015
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