Provider Demographics
NPI:1639302888
Name:MALEWSKI, SARA (NP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MALEWSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45440 PLATT ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48317-5666
Mailing Address - Country:US
Mailing Address - Phone:586-876-8399
Mailing Address - Fax:866-616-0686
Practice Address - Street 1:45440 PLATT ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5666
Practice Address - Country:US
Practice Address - Phone:586-876-8399
Practice Address - Fax:866-616-0686
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704180776363L00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner