Individual
SARA M MACKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
(920) 405-5388
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6810
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109859
AMERICAN ASSOCIATION OF NURSE ANESTHETISTS
—
Enumeration date
12/09/2015
Last updated
04/07/2023
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