Provider Demographics
NPI:1154063782
Name:BARBER, SARAH JOANN (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JOANN
Last Name:BARBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JOANN
Other - Last Name:WYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52742 ALAINA ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-3735
Mailing Address - Country:US
Mailing Address - Phone:727-642-4426
Mailing Address - Fax:
Practice Address - Street 1:14671 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3300
Practice Address - Country:US
Practice Address - Phone:313-948-3055
Practice Address - Fax:313-948-3041
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704303740163WE0003X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WE0003XNursing Service ProvidersRegistered NurseEmergency