Individual
NICOLE M SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
510 SMALTZ WAY, AUBURN, IN 46706-0612
(260) 927-1756
(260) 479-4639
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 927-1756
(260) 479-4639
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71006648A
IN
363LF0000X
Family Nurse Practitioner
28203112A
IN
Other
Enumeration date
09/19/2016
Last updated
09/20/2021
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