Sadie Mae Ellenberg, BSN, RN, CNOR, RNFA

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

CEO11471 Issued in CO

Practice address

1000 Coney St W
Perham, MN 56573-2102

Phone

(218) 347-1498

NPI assigned

Nov 15, 2021

Last updated

Nov 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1275299109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CONEY ST W",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565732102",
            "telephone_number": "218-347-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CONEY ST W",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565732102",
            "telephone_number": "218-347-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBERG",
        "first_name": "SADIE",
        "middle_name": "MAE",
        "credential": "BSN, RN, CNOR, RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "CO",
            "license": "CEO11471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Disse, DDS
• Hattie Rose Dorman
• Dr. Kelvin K. Salathe, P.C. (Salathe Chiropractic Center)
• Wanda Drewes, RPH
• East Ottertail Pharmacy (Perham Health Pharmacy)
• Empowering Kids Perham
• Daisy Ewing
• Jessi Lee Fish
• Timothy Richard Fresonke, PA-C
• Erin Carey Friedsam

• Registered Nurse First Assistant in Perham, MN
• Providers in Perham, MN by specialty
• Registered Nurse First Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.