Organization
SANDRA SPIERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA J. SPIERS NP (SOLE OWNER)
(601) 347-3029
Entity
Organization
Contact information
Practice address
117 N MAIN ST STE B, PICAYUNE, MS 39466-3936
(601) 347-3029
(601) 749-7100
Mailing address
107 WOODMONT DR, PICAYUNE, MS 39466-7658
(601) 347-3029
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04778509
—
MS
01
—
2831390
UNITED HEALTH CARE
MS
01
—
5121500067
MEDICARE
MS
01
—
640507572
TRICARE
MS
01
—
P00816371
RR MEDICARE
MS
Enumeration date
12/12/2014
Last updated
08/22/2023
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