Basic Information
| Provider Information | |||||||||
| NPI: | 1992158687 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAY | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN. CPNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4137 N 108TH AVE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850375459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6238777337 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4137 N 108TH AVE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850375459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6238777337 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2016 | ||||||||
| LastUpdateDate: | 06/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | AP8802 | AZ | N | Ambulatory Health Care Facilities | Clinic/Center | Primary Care | 363LP0200X | AP8802 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.