Individual
SARAH ANN KOLACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12563 STATE ROAD 23, GRANGER, IN 46530-9226
(574) 335-8300
(574) 335-0775
Mailing address
11652 DRAGOON TRL, MISHAWAKA, IN 46544-9734
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71007020A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005019
—
IN
Enumeration date
02/16/2017
Last updated
01/11/2022
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