Healthcare Provider Details

I. General information

NPI: 1659189694
Provider Name (Legal Business Name): SABRINA BISSONNETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 E RIGGS RD # 3960
CHANDLER AZ
85249-5410
US

IV. Provider business mailing address

3950 E RIGGS RD # 3960
CHANDLER AZ
85249-5410
US

V. Phone/Fax

Practice location:
  • Phone: 480-786-4441
  • Fax:
Mailing address:
  • Phone: 480-786-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number317069
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: