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General NPI Number Information
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NPI Number | 1962754259
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Entity Type | Individual
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Provider Name | SARAH JANE DRAEGER PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 1250 MERCY DR STE 101
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City | MUSKEGON
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State | MI
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Zip | 49444-1881
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Country | US
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Telephone | 231-733-1912
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Fax |
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Provider Business Mailing Address
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Address Line | 2067 OAKWOOD AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-4169
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Country | US
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Telephone | 616-218-9569
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601013166
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | NULL
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