Provider Demographics
NPI:1699132563
Name:SAGER, BETH A (CNA)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:SAGER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 SHERMAN CT
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1280
Mailing Address - Country:US
Mailing Address - Phone:810-441-5627
Mailing Address - Fax:
Practice Address - Street 1:1432 SHERMAN CT
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1280
Practice Address - Country:US
Practice Address - Phone:810-441-5627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-24
Last Update Date:2016-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI234127180890376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide