Provider Demographics
NPI:1801362892
Name:TUCKER, SARAH JOYCE (BC-WHNP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JOYCE
Last Name:TUCKER
Suffix:
Gender:F
Credentials:BC-WHNP
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:JOYCE
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13471 W CORNERSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2713
Mailing Address - Country:US
Mailing Address - Phone:160-240-0548
Mailing Address - Fax:
Practice Address - Street 1:13471 W CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2713
Practice Address - Country:US
Practice Address - Phone:480-964-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP116001363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health