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General NPI Number Information
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NPI Number | 1386214476
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Entity Type | Individual
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Provider Name | SARAH ELEAS RUCKER ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 850 BROADSTONE WAY APT 425
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-1634
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Country | US
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Telephone | 606-571-2464
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Fax |
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Provider Business Mailing Address
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Address Line | 850 BROADSTONE WAY APT 425
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-1634
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Country | US
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Telephone | 606-571-2464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11014017
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN9308690
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License Number State | FL
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