Healthcare Provider Details

I. General information

NPI: 1558876086
Provider Name (Legal Business Name): SARAH MARIE VROOMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 12/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 E VIRGINIA AVE
SCOTTSDALE AZ
85257-1522
US

IV. Provider business mailing address

7501 E VIRGINIA AVE
SCOTTSDALE AZ
85257-1522
US

V. Phone/Fax

Practice location:
  • Phone: 480-484-6811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN209238
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: