Individual
LORA D SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2920 S MCINTIRE DR STE 150A, BLOOMINGTON, IN 47403-4221
(765) 349-6793
(765) 349-6949
Mailing address
2920 S MCINTIRE DR STE 150A, BLOOMINGTON, IN 47403-4221
(765) 349-6793
(765) 349-6949
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71013418A
IN
363LP2300X
Primary Care Nurse Practitioner
71013418A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430G94
MEDICARE
IN
05
—
300072125
—
IN
Enumeration date
02/14/2023
Last updated
10/22/2023
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