Healthcare Provider Details

I. General information

NPI: 1801557905
Provider Name (Legal Business Name): SARAH DANIELLE LEGRAND AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2022
Last Update Date: 01/01/2022
Certification Date: 11/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10510 N 92ND ST
SCOTTSDALE AZ
85258-4566
US

IV. Provider business mailing address

8138 E VIA SONRISA
SCOTTSDALE AZ
85258-3725
US

V. Phone/Fax

Practice location:
  • Phone: 480-323-1350
  • Fax:
Mailing address:
  • Phone: 847-951-7655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN168637
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number263664
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: