Provider Demographics
NPI:1184162729
Name:BENNETT, SARA KAY (DNP, RNP, FNP)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:KAY
Last Name:BENNETT
Suffix:
Gender:F
Credentials:DNP, RNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2637
Mailing Address - Street 2:
Mailing Address - City:CLAYPOOL
Mailing Address - State:AZ
Mailing Address - Zip Code:85532-2637
Mailing Address - Country:US
Mailing Address - Phone:520-831-4676
Mailing Address - Fax:
Practice Address - Street 1:5860 S HOSPITAL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:GLOBE
Practice Address - State:AZ
Practice Address - Zip Code:85501-9449
Practice Address - Country:US
Practice Address - Phone:928-402-0491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily