Provider Demographics
NPI:1295597730
Name:SACHDEV, JASKANWAL K (NP)
Entity type:Individual
Prefix:
First Name:JASKANWAL
Middle Name:K
Last Name:SACHDEV
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 1:3125 E BEAUTIFUL LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-7117
Mailing Address - Country:US
Mailing Address - Phone:602-451-0820
Mailing Address - Fax:
Practice Address - Street 1:3125 E BEAUTIFUL LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-7117
Practice Address - Country:US
Practice Address - Phone:602-451-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZF09231306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily