Provider Demographics
NPI:1609344282
Name:DOYON, SARA A (NP-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:DOYON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-1358
Mailing Address - Country:US
Mailing Address - Phone:219-741-7655
Mailing Address - Fax:
Practice Address - Street 1:321 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1358
Practice Address - Country:US
Practice Address - Phone:219-741-7655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28199807A163W00000X
MI18306101128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1306101128OtherSTATE OF MICHIGANDEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BOARD OF NURSING