Individual
MIRANDA NICOLE SANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1176 TOWN AND COUNTRY COMMONS DR, TOWN AND COUNTRY, MO 63017-8200
(217) 663-5669
Mailing address
1176 TOWN AND COUNTRY COMMONS DR, TOWN AND COUNTRY, MO 63017-8200
(217) 663-5669
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041504517
IL
163W00000X
Registered Nurse
2017024672
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2021046352
MO
Other
Enumeration date
11/13/2021
Last updated
04/04/2022
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