Healthcare Provider Details

I. General information

NPI: 1548104920
Provider Name (Legal Business Name): SANDRA TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21001 N TATUM BLVD STE 18
PHOENIX AZ
85050-4207
US

IV. Provider business mailing address

9044 E NITTANY DR
SCOTTSDALE AZ
85255-5362
US

V. Phone/Fax

Practice location:
  • Phone: 602-229-4650
  • Fax:
Mailing address:
  • Phone: 602-295-4650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number2026022222
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: