Provider Demographics
NPI:1063057743
Name:PIRNESS, SARA BETH (PMHNP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:BETH
Last Name:PIRNESS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 E CACTUS RD
Mailing Address - Street 2:STE 505 #868
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-8116
Mailing Address - Country:US
Mailing Address - Phone:480-382-4152
Mailing Address - Fax:
Practice Address - Street 1:4848 E CACTUS RD STE 505
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4182
Practice Address - Country:US
Practice Address - Phone:480-382-4152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-17
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ249461363LP0808X
COC-APN.0003323-C-APN363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000198086Medicaid