Sabra J Van Orsdol, BSN,RN,PHN

Individual provider Active NPI Community Health Registered Nurse · Peridot, AZ

NPI 1639729429 · NPPES record last updated Sep 13, 2019

Key facts

NPI
1639729429
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
RN157794 (AZ)
Practice address
103 Medicine Way Rd
Peridot, AZ 85542-5000
Phone
(928) 475-1564
NPI assigned
Sep 13, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN157794AZMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN157794 AZ Yes

Addresses

Primary practice location

103 Medicine Way Rd
Peridot, AZ 85542-5000

Mailing address

PO Box 1702
Globe, AZ 85502-1702
Phone (928) 425-3512

Other providers in Peridot, AZ

All providers in Peridot, AZ · Community Health Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.