Individual
SANDRA NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4060 MEDICAL PARK DR, ODESSA, TX 79765-2233
(432) 582-2882
(432) 582-2884
Mailing address
4060 MEDICAL PARK DR, ODESSA, TX 79765-2233
(432) 582-2882
(432) 582-2884
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP133121
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372353802
—
TX
Enumeration date
05/11/2017
Last updated
05/14/2021
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