MEDICARE: SARAH JANE ALDOR FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP4127	AZ

General Provider Information

NPI Number	:	1487930699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH JANE ALDOR FNP

Provider Business Mailing Address
First Line	:	PO BOX 961
Second Line	:
City	:	VAIL
State	:	AZ
Zip	:	85641-0961
Country	:	US
Telephone Number	:	520-971-1157
Fax Number	:

Provider Business Practice Location Address
First Line	:	8920 E TANQUE VERDE RD
Second Line	:	CVS-MINUTE CLINIC #9302
City	:	TUCSON
State	:	AZ
Zip	:	85749-9604
Country	:	US
Telephone Number	:	520-760-9188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2011
Last Update Date	:	07/26/2014

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