Provider Demographics
NPI:1043080377
Name:LEACH, SARA (FNP-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LEACH
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:FUCHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10200 GRAND CENTRAL AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4366
Mailing Address - Country:US
Mailing Address - Phone:623-582-6420
Mailing Address - Fax:623-582-6720
Practice Address - Street 1:2902 W AGUA FRIA FWY STE 1000
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3969
Practice Address - Country:US
Practice Address - Phone:623-582-6420
Practice Address - Fax:623-582-6720
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ301537363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner