Provider Demographics
NPI:1437511896
Name:GROHMANN, SARAH (AGNP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GROHMANN
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 MESQUITE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5885
Mailing Address - Country:US
Mailing Address - Phone:928-453-0777
Mailing Address - Fax:
Practice Address - Street 1:2010 INJO DR
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5707
Practice Address - Country:US
Practice Address - Phone:928-216-3160
Practice Address - Fax:623-227-2000
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3162084N0400X
AZTAP83316363L00000X
AZAP8316363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology