Kelley-Pegg, Sarah

Kelley-Pegg, Sarah is an individual health care provider with primary practice located at 410 Church St Se , Minneapolis MN 55455-0222. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Kelley-Pegg, Sarah can be contacted via phone (612) 625-8400.

Contact Information

Primary practice address
410 Church St Se Minneapolis MN 55455-0222
Phone: (612) 625-8400
Fax: (612) 827-6403
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 0589 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R1287246 Minnesota

Profile Details

NPI number 1780883256
LBN Legal business name Kelley-Pegg, Sarah
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2007
Last updated Jan 9th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780883256 NPPES
Minnesota MEDICAID 337117000

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