Individual
MS. SARA MARIE GUDENKAUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5409 AVENUE O, FORT MADISON, IA 52627-9601
(319) 376-2134
(319) 376-2188
Mailing address
5409 AVENUE O, FORT MADISON, IA 52627-9601
(319) 376-2134
(319) 376-2188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
H138622
IA
363LC0200X
Critical Care Medicine Nurse Practitioner
111168
NE
363LF0000X
Family Nurse Practitioner
Primary
A138622
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098939002
MEDICARE PTAN
NE
Enumeration date
09/22/2010
Last updated
10/29/2014
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