Healthcare Provider Details

I. General information

NPI: 1427794643
Provider Name (Legal Business Name): ALISHA RENEE SAWYER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16430 W YUMA RD
GOODYEAR AZ
85338-3102
US

IV. Provider business mailing address

16430 W YUMA RD
GOODYEAR AZ
85338-3102
US

V. Phone/Fax

Practice location:
  • Phone: 623-465-6405
  • Fax: 623-465-6405
Mailing address:
  • Phone: 623-465-6405
  • Fax: 623-465-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRNP274675
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: