Provider Demographics
NPI:1982989265
Name:TUCCI, SARAH K (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:K
Last Name:TUCCI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:K
Other - Last Name:SLEDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2751 ALBERT L BICKNELL DR STE 3D
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3941
Mailing Address - Country:US
Mailing Address - Phone:318-212-6710
Mailing Address - Fax:318-212-6705
Practice Address - Street 1:2751 ALBERT L BICKNELL DR STE 3D
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3941
Practice Address - Country:US
Practice Address - Phone:318-212-6710
Practice Address - Fax:318-221-2670
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200496363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant