Provider Demographics
NPI:1326811555
Name:SPROAT, ANNE (DNP-C)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:SPROAT
Suffix:
Gender:F
Credentials:DNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 CORVETTE CT
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-9415
Mailing Address - Country:US
Mailing Address - Phone:616-481-5608
Mailing Address - Fax:
Practice Address - Street 1:8420 CORVETTE CT
Practice Address - Street 2:
Practice Address - City:JENISON
Practice Address - State:MI
Practice Address - Zip Code:49428-9415
Practice Address - Country:US
Practice Address - Phone:616-481-5608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704281353363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health