Provider Demographics
NPI:1649885872
Name:THUEME, SARA DAWN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:DAWN
Last Name:THUEME
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-0085
Mailing Address - Country:US
Mailing Address - Phone:810-982-8742
Mailing Address - Fax:
Practice Address - Street 1:1231 PINE GROVE AVE STE 2A
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3500
Practice Address - Country:US
Practice Address - Phone:810-982-8742
Practice Address - Fax:810-984-8291
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2021-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF09200306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily