Healthcare Provider Details

I. General information

NPI: 1831485390
Provider Name (Legal Business Name): SARAH ANDERSON CIANCIARULI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE FL 34994
STUART FL
34994-2346
US

IV. Provider business mailing address

PO BOX 9033
STUART FL
34995-9033
US

V. Phone/Fax

Practice location:
  • Phone: 772-370-8796
  • Fax: 772-223-5914
Mailing address:
  • Phone: 772-287-5200
  • Fax: 772-223-5622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9168913
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1215204
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: