Provider Demographics
NPI:1528828662
Name:MCMICHAEL, SARA L
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:MCMICHAEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7881 MERIDIAN LINE RD
Mailing Address - Street 2:
Mailing Address - City:JOHANNESBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49751-9582
Mailing Address - Country:US
Mailing Address - Phone:989-745-5553
Mailing Address - Fax:
Practice Address - Street 1:7881 MERIDIAN LINE RD
Practice Address - Street 2:
Practice Address - City:JOHANNESBURG
Practice Address - State:MI
Practice Address - Zip Code:49751-9582
Practice Address - Country:US
Practice Address - Phone:989-745-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide