Provider Demographics
NPI:1164926317
Name:FAUNT, SARAH ANNE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:FAUNT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:FRYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1306 N SILVERY LN
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1033
Mailing Address - Country:US
Mailing Address - Phone:734-476-0664
Mailing Address - Fax:
Practice Address - Street 1:1306 N SILVERY LN
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1033
Practice Address - Country:US
Practice Address - Phone:734-476-0664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704270997363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily