Healthcare Provider Details

I. General information

NPI: 1952955635
Provider Name (Legal Business Name): SARAH A PREHODA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 N 19TH AVE
PHOENIX AZ
85015-1646
US

IV. Provider business mailing address

26511 W MCRAE DR
BUCKEYE AZ
85396-2565
US

V. Phone/Fax

Practice location:
  • Phone: 602-795-6020
  • Fax:
Mailing address:
  • Phone: 765-585-7559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number233468
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: