Provider Demographics
NPI:1316100696
Name:SAZAMA, MICHELE ANNE (NP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANNE
Last Name:SAZAMA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51534
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85076-1534
Mailing Address - Country:US
Mailing Address - Phone:623-238-7600
Mailing Address - Fax:
Practice Address - Street 1:3501 N SCOTTSDALE RD STE 300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5638
Practice Address - Country:US
Practice Address - Phone:623-238-7600
Practice Address - Fax:480-946-9001
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP3034363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ416633Medicaid
AZZ128570Medicare PIN