MEDICARE: MS. JOANNA GLORIA SANFORD PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-07253	NC
2	363A00000X	Physician Assistant	7117	AZ

General Provider Information

NPI Number	:	1114369576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNA GLORIA SANFORD PA-C

Provider Business Mailing Address
First Line	:	13400 E SHEA BLVD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85259-5452
Country	:	US
Telephone Number	:	480-301-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 CARTHAGE ST
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-4162
Country	:	US
Telephone Number	:	919-774-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2013
Last Update Date	:	04/07/2026

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