Provider Demographics
NPI:1043600612
Name:GOEHMANN, SARAH (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GOEHMANN
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21800 HAGGERTY RD
Mailing Address - Street 2:STE 113
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-9051
Mailing Address - Country:US
Mailing Address - Phone:734-389-7103
Mailing Address - Fax:734-389-7103
Practice Address - Street 1:21800 HAGGERTY RD STE 113
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-9051
Practice Address - Country:US
Practice Address - Phone:888-882-3783
Practice Address - Fax:888-667-3531
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704223782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily