Provider Demographics
NPI:1184380768
Name:MOORE, SARAH B (RN)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:B
Last Name:MOORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:B
Other - Last Name:MORISETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:12050 ALBEE RD
Mailing Address - Street 2:
Mailing Address - City:BURT
Mailing Address - State:MI
Mailing Address - Zip Code:48417-9664
Mailing Address - Country:US
Mailing Address - Phone:248-390-0165
Mailing Address - Fax:
Practice Address - Street 1:12050 ALBEE RD
Practice Address - Street 2:
Practice Address - City:BURT
Practice Address - State:MI
Practice Address - Zip Code:48417-9664
Practice Address - Country:US
Practice Address - Phone:248-390-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704237785163WC2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC2100XNursing Service ProvidersRegistered NurseContinence CareGroup - Single Specialty