Healthcare Provider Details

I. General information

NPI: 1013116110
Provider Name (Legal Business Name): SARA ELIZABETH MASSARO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1863 EAST FLORENCE BLVD
CASA GRANDE AZ
85122-6011
US

IV. Provider business mailing address

PO BOX 96395
PHOENIX AZ
85072-6395
US

V. Phone/Fax

Practice location:
  • Phone: 520-836-3446
  • Fax:
Mailing address:
  • Phone: 520-836-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRNP235016
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN129776
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: