Provider Demographics
NPI:1053953000
Name:MCCARTNEY, SARAH RENEE (AGACNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W THOMAS RD STE 500
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4220
Mailing Address - Country:US
Mailing Address - Phone:602-406-8000
Mailing Address - Fax:602-406-3111
Practice Address - Street 1:500 W THOMAS RD STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4294
Practice Address - Country:US
Practice Address - Phone:602-406-8000
Practice Address - Fax:602-406-3111
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ231783363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ602477Medicaid