Provider Demographics
NPI:1457090326
Name:VOGT, SARAH RAYLENE (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RAYLENE
Last Name:VOGT
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 1:1350 N 77TH ST UNIT 2010
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3774
Mailing Address - Country:US
Mailing Address - Phone:415-686-3773
Mailing Address - Fax:
Practice Address - Street 1:3295 N DRINKWATER BLVD STE 13
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6493
Practice Address - Country:US
Practice Address - Phone:480-625-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ275568363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner