Healthcare Provider Details

I. General information

NPI: 1447971999
Provider Name (Legal Business Name): SARA LYNN GRUBOR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14520 W GRANITE VALLEY DR # 210
SUN CITY WEST AZ
85375-5855
US

IV. Provider business mailing address

18444 N 25TH AVE STE 310
PHOENIX AZ
85023-1266
US

V. Phone/Fax

Practice location:
  • Phone: 866-974-2673
  • Fax:
Mailing address:
  • Phone: 866-974-2673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number280338
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number280338
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: