Provider Demographics
NPI:1386303303
Name:SAPPHIRE ADULT HEALTH NP, P.C.
Entity type:Organization
Organization Name:SAPPHIRE ADULT HEALTH NP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAVONN
Authorized Official - Middle Name:CRYSTAL
Authorized Official - Last Name:STALLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:347-731-4284
Mailing Address - Street 1:3 GERRI CT
Mailing Address - Street 2:
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589-2777
Mailing Address - Country:US
Mailing Address - Phone:845-288-0556
Mailing Address - Fax:
Practice Address - Street 1:3 GERRI CT
Practice Address - Street 2:
Practice Address - City:WALLKILL
Practice Address - State:NY
Practice Address - Zip Code:12589-2777
Practice Address - Country:US
Practice Address - Phone:845-288-0556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health