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Individual
DEIDRA HENLEY SANDERS
Active
Individual
DEIDRA HENLEY SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2338P
KY
363L00000X
Nurse Practitioner
Primary
3002338
KY
363L00000X
Nurse Practitioner
71000277A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1050107
PASSPORT PROVIDER NUMBER
KY
Enumeration date
07/26/2005
Last updated
10/29/2013
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