Healthcare Provider Details

I. General information

NPI: 1083150205
Provider Name (Legal Business Name): SANNA NEFF FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2017
Last Update Date: 10/01/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16515 S 40TH ST STE 143
PHOENIX AZ
85048-0560
US

IV. Provider business mailing address

16515 S 40TH ST STE 143
PHOENIX AZ
85048-0560
US

V. Phone/Fax

Practice location:
  • Phone: 480-712-8319
  • Fax: 480-712-1305
Mailing address:
  • Phone: 480-712-8319
  • Fax: 480-712-1305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP9794
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: