Provider Demographics
NPI:1699551655
Name:MARX, SARAH GRACE (LPN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:MARX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:GRACE
Other - Last Name:JURICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:933 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-1825
Mailing Address - Country:US
Mailing Address - Phone:734-497-0364
Mailing Address - Fax:
Practice Address - Street 1:3250 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-9297
Practice Address - Country:US
Practice Address - Phone:734-384-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703121151164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse