Provider Demographics
NPI:1548140106
Name:TRUMBLEY, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TRUMBLEY
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 1:1421 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-9524
Mailing Address - Country:US
Mailing Address - Phone:269-930-7465
Mailing Address - Fax:
Practice Address - Street 1:1421 WILSON RD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9524
Practice Address - Country:US
Practice Address - Phone:269-930-7465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA246ZI1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZI1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherIllustration, Medical