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NPI Code Detail

MEDICARE: MRS. SARAH KRASNICK NURSE PRACTITIONER

MEDICARE:  MRS. SARAH  KRASNICK  NURSE PRACTITIONER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner4704154415MI
2363LP0808XPsychiatric/Mental Health Nurse Practitioner4704154415MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1500F324120OTHERMIBCBSM

General Provider Information

NPI Number : 1578718433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARAH KRASNICK NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 24111 SOUTHFIELD RD
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-2841
Country : US
Telephone Number : 248-557-8800
Fax Number : 248-557-8860
Provider Business Practice Location Address
First Line : 441 S LIVERNOIS RD STE 100
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-2585
Country : US
Telephone Number : 248-608-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2008
Last Update Date : 03/10/2021

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Directions to “ MRS. SARAH KRASNICK NURSE PRACTITIONER” Practice Location

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