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General NPI Number Information
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NPI Number | 1669046504
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Entity Type | Individual
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Provider Name | SARA K MUNRO
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Gender | Female
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Dates
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Enumeration Date | 05/15/2021
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 11275 ALLEN RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-3380
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Country | US
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Telephone | 313-383-7194
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Fax | 313-383-7194
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Provider Business Mailing Address
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Address Line | 15750 GULLEY ST
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City | TAYLOR
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State | MI
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Zip | 48180-5024
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Country | US
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Telephone | 313-319-4490
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704249129
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License Number State | MI
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