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Individual
SHIRLEY JOANNE SANDERS
Active
Individual
SHIRLEY JOANNE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000212
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000990928
ANTHEM PIN
IN
01
—
054962P
SIHO
IN
01
—
1407861164
GROUP NPI
—
05
—
201085480
—
IN
01
—
500011512
MEDICARE RAILROAD
IN
01
—
71000212
IN NP LINCENSE
IN
Enumeration date
05/03/2006
Last updated
08/03/2016
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