Healthcare Provider Details

I. General information

NPI: 1891332672
Provider Name (Legal Business Name): SARAH YSKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2019
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 EAGLE RUN DR NE STE 103
GRAND RAPIDS MI
49525-7069
US

IV. Provider business mailing address

3300 EAGLE RUN DR NE STE 103
GRAND RAPIDS MI
49525-7069
US

V. Phone/Fax

Practice location:
  • Phone: 614-360-9995
  • Fax: 844-571-1777
Mailing address:
  • Phone: 614-360-9995
  • Fax: 844-571-1777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF09190803
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: