Provider Demographics
NPI:1689773301
Name:VERBURG, SARAH E (FNP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:VERBURG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W. GREEN ST
Mailing Address - Street 2:STE 304
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058
Mailing Address - Country:US
Mailing Address - Phone:269-948-8057
Mailing Address - Fax:269-331-6315
Practice Address - Street 1:1005 W. GREEN ST
Practice Address - Street 2:STE 304
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058
Practice Address - Country:US
Practice Address - Phone:269-948-8057
Practice Address - Fax:269-331-6315
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI43032332363L00000X
MI4704208860363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP88363Medicare UPIN
0M28750019Medicare PIN