Provider Demographics
NPI:1588234058
Name:LENTZ, SARA KAY (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:KAY
Last Name:LENTZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:KAY
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:11731 MILLSTONE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-2268
Mailing Address - Country:US
Mailing Address - Phone:517-896-4058
Mailing Address - Fax:
Practice Address - Street 1:11731 MILLSTONE DR
Practice Address - Street 2:
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-2268
Practice Address - Country:US
Practice Address - Phone:517-896-4058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF06210491363L00000X
MI4704324477363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner