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NPI 1962157586

NPI 1962157586 : SARAH ELAINE CORGAN NP : LANSING, MI

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General NPI Number Information
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    NPI Number           |    1962157586
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH ELAINE CORGAN NP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/14/2022
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    Last Update Date     |    03/25/2025
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Provider Practice Location Address
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    Address Line         |    3955 PATIENT CARE DR STE A 
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    City                 |    LANSING
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    State                |    MI
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    Zip                  |    48911-4271
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    Country              |    US
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    Telephone            |    517-374-7600
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    Fax                  |    885-480-9150
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Provider Business Mailing Address
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    Address Line         |    3955 PATIENT CARE DR STE A 
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    City                 |    LANSING
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    State                |    MI
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    Zip                  |    48911-4271
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    Country              |    US
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    Telephone            |    517-374-7600
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    Fax                  |    885-480-9150
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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        |    207RI0200X
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    Taxonomy Name        |    Infectious Disease Physician
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    License Number       |    4704230974
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    License Number State |    MI
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Taxonomy #2
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    Taxonomy Code        |    363LG0600X
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    Taxonomy Name        |    Gerontology Nurse Practitioner
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    License Number       |    4704230974
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    License Number State |    MI
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