Healthcare Provider Details

I. General information

NPI: 1104256577
Provider Name (Legal Business Name): SABINE GARRETT-SHORTY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 E UNIVERSITY DR
MESA AZ
85203-8237
US

IV. Provider business mailing address

1840 E UNIVERSITY DR
MESA AZ
85203-8237
US

V. Phone/Fax

Practice location:
  • Phone: 480-268-2670
  • Fax:
Mailing address:
  • Phone: 480-268-2670
  • Fax: 480-646-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP9644
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number06-966
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: