Provider Demographics
NPI:1033515697
Name:UNDERWOOD-STANKEVICH, SARA L (FNP-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:UNDERWOOD-STANKEVICH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:L
Other - Last Name:UNDERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7125 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3615
Mailing Address - Country:US
Mailing Address - Phone:248-865-7481
Mailing Address - Fax:248-865-7469
Practice Address - Street 1:10415 GRAND RIVER RD STE 100
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-6533
Practice Address - Country:US
Practice Address - Phone:810-227-1020
Practice Address - Fax:810-227-4930
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704273774163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse