# ADVANCED PRACTICE NURSE SOURCE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790536654
- **Authorized official:** MELISSA ANN MILLER SARHAN APRN (CEO)
- **Authorized official phone:** (801) 550-6059

## Contact information

- **Practice address:** 12772 N 58TH AVE, GLENDALE, AZ 85304-1878
- **Practice address phone:** (801) 550-6059
- **Mailing address:** 5830 W THUNDERBIRD RD STE B8118, GLENDALE, AZ 85306-4654

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/28/2024
- **Last updated:** 03/28/2024