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NPI Code Detail

MEDICARE: SARA KARL-LUSARDI NP

MEDICARE: SARA KARL-LUSARDI NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner4704306640MI

General Provider Information

NPI Number : 1053995944
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA KARL-LUSARDI NP
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE
Second Line : MC 845
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2900 BRADFORD ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-6427
Country : US
Telephone Number : 616-885-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2021
Last Update Date : 06/01/2026

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Directions to “ SARA KARL-LUSARDI NP” Practice Location

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