Provider Demographics
NPI:1417103714
Name:RAY, SARAH ANN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:RAY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:MCKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:419 S CORAL ST
Mailing Address - Street 2:
Mailing Address - City:KALKASKA
Mailing Address - State:MI
Mailing Address - Zip Code:49646-2503
Mailing Address - Country:US
Mailing Address - Phone:231-258-7500
Mailing Address - Fax:
Practice Address - Street 1:419 S CORAL ST
Practice Address - Street 2:
Practice Address - City:KALKASKA
Practice Address - State:MI
Practice Address - Zip Code:49646-2503
Practice Address - Country:US
Practice Address - Phone:231-258-7777
Practice Address - Fax:231-258-7786
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3113363LF0000X
MI4704366623363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily