Individual
CARRIE ANNE SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 664-2255
Mailing address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 664-2255
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
591190-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16-6002567
—
NY
Enumeration date
03/04/2021
Last updated
03/04/2021
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