Individual
EMILLIA MARIE BRATANOV SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 N OLD WILDERNESS RD, NIXA, MO 65714-9490
(417) 269-2227
Mailing address
1821 E VINCENT DR, SPRINGFIELD, MO 65804-4313
(417) 766-5483
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2025009903
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/13/2025
Last updated
05/09/2025
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