Provider Demographics
NPI:1518116656
Name:BRIGGS, SARA I (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:I
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 E LINCOLN DR STE B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-2301
Mailing Address - Country:US
Mailing Address - Phone:602-252-3829
Mailing Address - Fax:602-252-3846
Practice Address - Street 1:3135 E LINCOLN DR STE B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2301
Practice Address - Country:US
Practice Address - Phone:602-252-3829
Practice Address - Fax:602-252-3846
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4248363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ371036Medicaid
AZZ173120Medicare PIN