Provider Demographics
NPI:1205859501
Name:ENGSTER, SARAH L (ANP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:ENGSTER
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-373-1222
Mailing Address - Fax:269-373-6270
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-373-1222
Practice Address - Fax:269-373-6270
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704159873363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1003822412OtherBCBSM - BRONSON
MI1205859501Medicaid
MI0M99460Medicare ID - Type Unspecified
MIN54580033 - BRONSONMedicare PIN
MIP42368Medicare UPIN