Provider Demographics
NPI:1891342945
Name:SANDERS, TIERRA
Entity type:Individual
Prefix:
First Name:TIERRA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2617
Mailing Address - Country:US
Mailing Address - Phone:480-677-8282
Mailing Address - Fax:888-316-1686
Practice Address - Street 1:7435 W CACTUS RD # A-125
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5300
Practice Address - Country:US
Practice Address - Phone:480-677-8282
Practice Address - Fax:844-470-2777
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-23
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9833363AM0700X, 363AM0700X
AZ7047150001332B00000X
AZ7629170001332B00000X
AZ7046960001332B00000X
AZ7057360001332B00000X
AZ70349500001332B00000X
AZ8220410001332B00000X
AZ7209350001332B00000X
AZ704516001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies