MEDICARE: SARA SHAYAN 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	267602	AZ
2	363LP2300X	Primary Care Nurse Practitioner	267602	AZ

General Provider Information

NPI Number	:	1629737390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA SHAYAN FNP

Provider Business Mailing Address
First Line	:	603 N WILMOT RD STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2701
Country	:	US
Telephone Number	:	520-790-1556
Fax Number	:

Provider Business Practice Location Address
First Line	:	603 N WILMOT RD STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2701
Country	:	US
Telephone Number	:	520-790-1556
Fax Number	:	520-620-9719

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

Provider Enumeration Date	:	12/09/2021
Last Update Date	:	12/16/2025

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Directions to “ SARA SHAYAN FNP” Practice Location

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