Provider Demographics
NPI:1639588007
Name:DEGNAN, SARAH (CPNP, CNM)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DEGNAN
Suffix:
Gender:F
Credentials:CPNP, CNM
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:OHLSSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2137
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48012-2137
Mailing Address - Country:US
Mailing Address - Phone:248-872-1200
Mailing Address - Fax:
Practice Address - Street 1:1428 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1437
Practice Address - Country:US
Practice Address - Phone:248-872-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-10
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704276728363LP0200X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics