Basic Information
Provider Information
NPI: 1154886547
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUGGLE
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2929 E THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850168034
CountryCode: US
TelephoneNumber: 6024705000
FaxNumber:  
Practice Location
Address1: 12428 W THUNDERBIRD RD
Address2:  
City: EL MIRAGE
State: AZ
PostalCode: 85335
CountryCode: US
TelephoneNumber: 6233446500
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/10/2019
LastUpdateDate: 04/29/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP11563AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home