Individual
PENNY MARIE SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
2500 DELL RANGE BLVD, CHEYENNE, WY 82009-5273
(307) 630-4729
(307) 632-3298
Mailing address
PO BOX 20092, CHEYENNE, WY 82003-7002
(307) 630-4729
(307) 632-3298
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
111108
NE
363LF0000X
Family Nurse Practitioner
Primary
30342.1158
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025914400
—
NE
05
—
47051963312
—
NE
Enumeration date
02/02/2010
Last updated
10/09/2024
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