Healthcare Provider Details

I. General information

NPI: 1649114828
Provider Name (Legal Business Name): NIAPATH MOBILE L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 REYNARD ST SE
GRAND RAPIDS MI
49507-3613
US

IV. Provider business mailing address

925 REYNARD ST SE
GRAND RAPIDS MI
49507-3613
US

V. Phone/Fax

Practice location:
  • Phone: 616-389-5360
  • Fax: 616-389-5360
Mailing address:
  • Phone: 616-389-5360
  • Fax: 616-389-5360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARION SATTA-GABLE SARJO
Title or Position: OWNER/NURSE PRACTITIONER
Credential: NP
Phone: 616-389-5360