Healthcare Provider Details

I. General information

NPI: 1831834084
Provider Name (Legal Business Name): SARAH KATHLEEN BRYDEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32255 NORTHWESTERN HWY STE 197
FARMINGTON HILLS MI
48334-1566
US

IV. Provider business mailing address

32255 NORTHWESTERN HWY STE 197
FARMINGTON HILLS MI
48334-1566
US

V. Phone/Fax

Practice location:
  • Phone: 833-660-0933
  • Fax: 248-928-0967
Mailing address:
  • Phone: 833-660-0933
  • Fax: 248-928-0967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704337862
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704337862
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: