Individual
THOMAS DAVID SANDERSON
Active
Individual
THOMAS DAVID SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
201904282RN
OR
363L00000X
Nurse Practitioner
201904283NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
Primary
201904283NP-PP
OR
Other
Enumeration date
12/19/2019
Last updated
04/03/2026
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