=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831933183
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SADIE MADISON WESTPHAL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2024
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1711 S STEPHENSON AVE STE 210
-----------------------------------------------------
City | IRON MOUNTAIN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49801-3649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 906-776-5800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 417 16TH AVE
-----------------------------------------------------
City | NORWAY
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49870-1039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 906-221-4699
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 4704356772
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------