Provider Demographics
NPI:1467780437
Name:JASPERS, SARAH LYNN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LYNN
Last Name:JASPERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LYNN
Other - Last Name:DANGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5204
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-0603
Mailing Address - Country:US
Mailing Address - Phone:623-889-3477
Mailing Address - Fax:623-889-3478
Practice Address - Street 1:750 N ESTRELLA PKWY STE 40
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338
Practice Address - Country:US
Practice Address - Phone:623-889-3477
Practice Address - Fax:623-889-3478
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4553363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant