Healthcare Provider Details

I. General information

NPI: 1699305631
Provider Name (Legal Business Name): PURITY JEBET SANG FNP- BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8573 E PRINCESS DR STE 221
SCOTTSDALE AZ
85255-7825
US

IV. Provider business mailing address

4035 S RIVERPOINT PKWY
PHOENIX AZ
85040-0723
US

V. Phone/Fax

Practice location:
  • Phone: 480-656-4048
  • Fax: 480-247-6146
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number236097
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number236097
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: