Healthcare Provider Details

I. General information

NPI: 1750924973
Provider Name (Legal Business Name): CARRIE SANBORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2019
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 S SAGINAW RD
MIDLAND MI
48640-5633
US

IV. Provider business mailing address

3030 W PRAIRIE RD
SHEPHERD MI
48883-9647
US

V. Phone/Fax

Practice location:
  • Phone: 989-835-4041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: