Provider Demographics
NPI:1336028596
Name:SARPONG, CYNTHIA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:SARPONG
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 MORGAN LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-5703
Mailing Address - Country:US
Mailing Address - Phone:248-773-6381
Mailing Address - Fax:
Practice Address - Street 1:5516 MORGAN LAKE DR
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-5703
Practice Address - Country:US
Practice Address - Phone:248-773-6381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704348256363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care