Provider Demographics
NPI:1295444339
Name:SAUCIER, CORY
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:
Last Name:SAUCIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 PARK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4333
Mailing Address - Country:US
Mailing Address - Phone:904-482-7673
Mailing Address - Fax:
Practice Address - Street 1:2328 PARK ST APT 3
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4333
Practice Address - Country:US
Practice Address - Phone:904-538-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker