Provider Demographics
NPI:1447826870
Name:BEULLA, SARAH (BS QIDP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BEULLA
Suffix:
Gender:F
Credentials:BS QIDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 68TH ST SW STE 150
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49548-7144
Mailing Address - Country:US
Mailing Address - Phone:989-280-8686
Mailing Address - Fax:
Practice Address - Street 1:160 68TH ST SW STE 150
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49548-7144
Practice Address - Country:US
Practice Address - Phone:616-915-3226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator