Provider Demographics
NPI:1225394133
Name:SPARROW HEALTH SYSTEM
Entity Type:Organization
Organization Name:SPARROW HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIPOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-364-2122
Mailing Address - Street 1:3007 TRAPPERS COVE TRL
Mailing Address - Street 2:APT. 1B
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-8506
Mailing Address - Country:US
Mailing Address - Phone:231-679-1663
Mailing Address - Fax:
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1811
Practice Address - Country:US
Practice Address - Phone:517-364-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty