Healthcare Provider Details

I. General information

NPI: 1326443508
Provider Name (Legal Business Name): SARAH NICOLE BREAKIRON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 S WILLOW DR
TEMPE AZ
85283-4169
US

IV. Provider business mailing address

6600 S WILLOW DR
TEMPE AZ
85283-4169
US

V. Phone/Fax

Practice location:
  • Phone: 602-708-6184
  • Fax:
Mailing address:
  • Phone: 602-708-6184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN187815
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN187815
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: