Provider Demographics
NPI:1104157098
Name:PENZEL, SARAH MARIE (NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:PENZEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2313 E HILL RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5059
Mailing Address - Country:US
Mailing Address - Phone:810-953-6400
Mailing Address - Fax:810-953-6477
Practice Address - Street 1:401 S BALLENGER HWY
Practice Address - Street 2:PHYSICIAN BILLING
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3638
Practice Address - Country:US
Practice Address - Phone:810-342-1000
Practice Address - Fax:810-342-1590
Is Sole Proprietor?:No
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704270819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily