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Sarah Katherine Donovan

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

2801 W Kinnickinnic River Pkwy Ste 330, Milwaukee, WI 53215-3678

PECOS Enrollment

Based on the most recent information from CMS, provider Sarah Katherine Donovan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:26 AM.

Profile Details

Provider ID
1952681512
Provider Type
Individual
Full Name
Donovan, Sarah Katherine
Title
Mrs.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
8/26/2011
Last Updated
2/17/2020

Contact Information

Practice Location

2801 W Kinnickinnic River Pkwy Ste 330, Milwaukee, WI 53215-3678

(414) 649-1280

Unlisted Fax

Mailing Location

3301 W Forest Home Ave, Milwaukee, WI 53215-2843

(414) 389-2377

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 2800-023 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 100027571	Description Medicaid	Issuer Unlisted Wisconsin

Sarah Katherine Donovan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Kamelle, Christine B

Tokarz, Casey M

Campbell, Spencer A

Zimmerman, Cody R

Dickmann, Alexis C

Fehrenbacher, Timothy Allen

Mertens, Alix

Lacoursiere, Benjamin Alan

Lindblad, Mary A

Rogers, Krista N