Healthcare Provider Details

I. General information

NPI: 1831933183
Provider Name (Legal Business Name): SADIE MADISON WESTPHAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 S STEPHENSON AVE STE 210
IRON MOUNTAIN MI
49801-3649
US

IV. Provider business mailing address

417 16TH AVE
NORWAY MI
49870-1039
US

V. Phone/Fax

Practice location:
  • Phone: 906-776-5800
  • Fax:
Mailing address:
  • Phone: 906-221-4699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704356772
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: