Healthcare Provider Details

I. General information

NPI: 1477834695
Provider Name (Legal Business Name): SANA LIANE GAFFNEY P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2939 S SHERIDAN RD
STANTON MI
48888-9285
US

IV. Provider business mailing address

2939 S SHERIDAN RD
STANTON MI
48888-9285
US

V. Phone/Fax

Practice location:
  • Phone: 989-831-9009
  • Fax: 989-607-6875
Mailing address:
  • Phone: 989-831-9009
  • Fax: 989-607-6875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number5601006102
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5601006102
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: