Healthcare Provider Details

I. General information

NPI: 1700706975
Provider Name (Legal Business Name): MRS. SARAH LYNN RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH ANGER

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2169 E WILLARD RD
CLIO MI
48420-7702
US

IV. Provider business mailing address

2169 E WILLARD RD
CLIO MI
48420-7702
US

V. Phone/Fax

Practice location:
  • Phone: 810-869-2962
  • Fax:
Mailing address:
  • Phone: 810-869-2962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704355553
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: