Provider Demographics
NPI:1497000269
Name:VANCE, SARAH ANN (AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANN
Last Name:VANCE
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5654 PARKSIDE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-3941
Mailing Address - Country:US
Mailing Address - Phone:734-790-0937
Mailing Address - Fax:
Practice Address - Street 1:18302 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-5007
Practice Address - Country:US
Practice Address - Phone:248-478-1500
Practice Address - Fax:248-478-2798
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704241489363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology