Provider Demographics
NPI:1447347026
Name:SANDAGER, KRISTEN ANN (RNC APNP)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:ANN
Last Name:SANDAGER
Suffix:
Gender:F
Credentials:RNC APNP
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:ANN
Other - Last Name:WANGENSTEEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:622 RASSBACH ST
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701
Mailing Address - Country:US
Mailing Address - Phone:715-839-7663
Mailing Address - Fax:
Practice Address - Street 1:STUDENT HEALTH SERVICE NW
Practice Address - Street 2:CREST WELLNESS CENTER
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701
Practice Address - Country:US
Practice Address - Phone:715-836-4311
Practice Address - Fax:715-836-5979
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI86418030163W00000X
WI639033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse