Basic Information
Provider Information
NPI: 1730478280
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHARER
FirstName: SARAH
MiddleName: KENNEDY
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: KENNEDY
OtherFirstName: SARAH
OtherMiddleName: ELIZABETH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3030 N CENTRAL AVE STE 1001
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122716
CountryCode: US
TelephoneNumber: 6024064786
FaxNumber: 9166364358
Practice Location
Address1: 500 W THOMAS RD STE 720&730
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850134224
CountryCode: US
TelephoneNumber: 6024063715
FaxNumber: 6024064011
Other Information
ProviderEnumerationDate: 04/05/2011
LastUpdateDate: 07/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X50066AZY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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