Provider Demographics
NPI:1457916538
Name:SUNRISE FAMILY HEALTHCARE INC
Entity Type:Organization
Organization Name:SUNRISE FAMILY HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIARRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SITZER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:928-854-2568
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86405-0115
Mailing Address - Country:US
Mailing Address - Phone:928-854-2568
Mailing Address - Fax:
Practice Address - Street 1:1945 MESQUITE AVE STE A
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5889
Practice Address - Country:US
Practice Address - Phone:928-453-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-05
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty