Healthcare Provider Details

I. General information

NPI: 1144169210
Provider Name (Legal Business Name): SARAH ROGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 W TARO LN
PHOENIX AZ
85027-4826
US

IV. Provider business mailing address

3237 W TARO LN
PHOENIX AZ
85027-4826
US

V. Phone/Fax

Practice location:
  • Phone: 920-254-4765
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number239968
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: