Healthcare Provider Details

I. General information

NPI: 1508425976
Provider Name (Legal Business Name): SARAH J NEINAS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 08/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E MAIN ST
SPRING ARBOR MI
49283-9701
US

IV. Provider business mailing address

106 E MAIN ST
SPRING ARBOR MI
49283-9701
US

V. Phone/Fax

Practice location:
  • Phone: 517-750-6367
  • Fax:
Mailing address:
  • Phone: 517-750-6742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704234349
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: