Healthcare Provider Details

I. General information

NPI: 1487781092
Provider Name (Legal Business Name): SARAH E NEUMANN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 E AGAVE RD 148
PHOENIX AZ
85044-0619
US

IV. Provider business mailing address

783 W BLUEBIRD DR
CHANDLER AZ
85248-2611
US

V. Phone/Fax

Practice location:
  • Phone: 480-785-7546
  • Fax: 480-704-7549
Mailing address:
  • Phone: 480-516-7115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2590
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: