Individual
MS. DEBORA IVY SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1300 ENTERPRISE RD., SOCORRO, NM 87801
(575) 835-4444
Mailing address
29212 US 127, PIKEVILLE, TN 37367-4450
(940) 453-5788
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
65006
NM
363LF0000X
Family Nurse Practitioner
AP114027
TX
363LF0000X
Family Nurse Practitioner
Primary
CNP231074
ME
Other
Enumeration date
09/26/2005
Last updated
08/16/2024
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