Provider Demographics
NPI:1669643284
Name:BARRETT, SARA A
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45964 BRENTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-5410
Mailing Address - Country:US
Mailing Address - Phone:616-301-8000
Mailing Address - Fax:248-338-7513
Practice Address - Street 1:45964 BRENTWOOD ST
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-5410
Practice Address - Country:US
Practice Address - Phone:616-301-8000
Practice Address - Fax:248-338-7513
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704106518163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse