Provider Demographics
NPI:1639524804
Name:SUDANO, LI-TING (FNP)
Entity Type:Individual
Prefix:
First Name:LI-TING
Middle Name:
Last Name:SUDANO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 N ORACLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4448
Mailing Address - Country:US
Mailing Address - Phone:520-408-1133
Mailing Address - Fax:520-408-2233
Practice Address - Street 1:7520 N ORACLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4448
Practice Address - Country:US
Practice Address - Phone:520-408-1133
Practice Address - Fax:520-408-2233
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8650363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily