Provider Demographics
NPI:1972588614
Name:BARCELO-ADAIR, SANDRA ALICIA (ARNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ALICIA
Last Name:BARCELO-ADAIR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:ALICIA
Other - Last Name:BARCELO-ADAIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:95 SOLDIERS PASS RD STE B
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-4781
Mailing Address - Country:US
Mailing Address - Phone:928-203-4844
Mailing Address - Fax:
Practice Address - Street 1:95 SOLDIERS PASS RD
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4781
Practice Address - Country:US
Practice Address - Phone:928-203-4844
Practice Address - Fax:928-203-4497
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3451163WP2201X, 364SF0001X
FLARNP2712912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ303702Medicaid
FL303702900Medicaid
AZ303702900Medicaid