Provider Demographics
NPI:1629443783
Name:SAP, AMY S (LPN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:SAP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20050 W. INDIAN SCHOOL ROAD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX,
Mailing Address - State:AZ
Mailing Address - Zip Code:85396
Mailing Address - Country:US
Mailing Address - Phone:623-932-7400
Mailing Address - Fax:623-932-0369
Practice Address - Street 1:20050 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-7201
Practice Address - Country:US
Practice Address - Phone:623-932-7400
Practice Address - Fax:623-932-0369
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPN047889164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse