Sarah Catherine Ellis, FNP
Nurse Practitioner, Family in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1316618085
StatusActive
Last updated in NPPESNov 5, 2024
Details
- NPI
- 1316618085
- Entity type
- Individual (NPI-1)
- Name
- Sarah Catherine Ellis
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 23, 2021
- Certification date
- Nov 5, 2024
- Last updated
- Nov 5, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 4704330329 | MI | Yes |
Other names
- Sarah Catherine Personke (Former Name)
Practice location
2770 E Beltline Ave NeGrand Rapids, MI 49525-8614
Phone 616-267-8860
Mailing address
100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560
Phone 616-486-6790
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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