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General NPI Number Information
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NPI Number | 1841878113
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Entity Type | Individual
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Provider Name | SARA ELISABETH TIERCE-HAZARD AGPCNP-BC, PHMNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 174 S FREEPORT RD STE 2A
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City | FREEPORT
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State | ME
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Zip | 04032-6145
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Country | US
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Telephone | 207-977-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 224 TUTTLE RD
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City | CUMBERLAND
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State | ME
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Zip | 04021-4116
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Country | US
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Telephone | 703-772-4997
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP023260
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | SP023260
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP023260
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP251367
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License Number State | ME
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