Provider Demographics
NPI:1841878113
Name:TIERCE-HAZARD, SARA ELISABETH (AGPCNP-BC, PHMNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ELISABETH
Last Name:TIERCE-HAZARD
Suffix:
Gender:F
Credentials:AGPCNP-BC, PHMNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 TUTTLE RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04021-4116
Mailing Address - Country:US
Mailing Address - Phone:703-772-4997
Mailing Address - Fax:
Practice Address - Street 1:174 S FREEPORT RD STE 2A
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-6145
Practice Address - Country:US
Practice Address - Phone:207-977-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023260363LA2200X, 363LG0600X, 363LP2300X
MECNP251367363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care