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Individual
JESSICA MARIE SANFORD
Active
Individual
JESSICA MARIE SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A170959
IA
208D00000X
General Practice Physician
A170959
IA
363LF0000X
Family Nurse Practitioner
A170959
IA
Other
Enumeration date
09/08/2022
Last updated
10/19/2022
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