Provider Demographics
NPI:1508887670
Name:EMERY, SARA HUSCHKE (RN, ANP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:HUSCHKE
Last Name:EMERY
Suffix:
Gender:F
Credentials:RN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11209 N TATUM BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3092
Mailing Address - Country:US
Mailing Address - Phone:480-285-2180
Mailing Address - Fax:480-285-2182
Practice Address - Street 1:11209 N TATUM BLVD STE 160
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3092
Practice Address - Country:US
Practice Address - Phone:480-285-2180
Practice Address - Fax:480-285-2182
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1226363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP1226OtherLICENSE
AZAP1226OtherLICENSE
AZAP1226OtherLICENSE
MH0791170OtherDEA