MEDICARE: SARAH KIRONDE N.P.

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
1	363L00000X	Nurse Practitioner	4704240894	MI
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	4704240894	MI
3	363LP2300X	Primary Care Nurse Practitioner	4704240894	MI
4	363LF0000X	Family Nurse Practitioner	4707240894	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	700E012740	OTHER	MN	BCBS GROUP PIN

General Provider Information

NPI Number	:	1316372980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH KIRONDE N.P.

Provider Business Mailing Address
First Line	:	23332 FARMINGTON RD # 216
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-9998
Country	:	US
Telephone Number	:	313-378-9567
Fax Number	:	248-970-8501

Provider Business Practice Location Address
First Line	:	5003 FERNWOOD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48204
Country	:	US
Telephone Number	:	313-378-9567
Fax Number	:	248-970-8501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2013
Last Update Date	:	03/02/2026

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