Provider Demographics
NPI:1225458425
Name:BARRETT, SARA S (FNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:S
Last Name:BARRETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14510 W SHUMWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5815
Mailing Address - Country:US
Mailing Address - Phone:623-975-1660
Mailing Address - Fax:623-584-4282
Practice Address - Street 1:14510 W SHUMWAY DR STE 101
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5815
Practice Address - Country:US
Practice Address - Phone:623-975-1660
Practice Address - Fax:623-584-4282
Is Sole Proprietor?:No
Enumeration Date:2014-04-26
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5568363L00000X, 363LF0000X
AZRN120817363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ914154Medicaid