Individual
MS. SANDRA K BAMMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5150 SHELBYVILLE RD, INDIANAPOLIS, IN 46237-2601
(317) 782-1577
(317) 780-5539
Mailing address
5150 SHELBYVILLE RD, INDIANAPOLIS, IN 46237-2601
(317) 782-1577
(317) 780-5539
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28076646
IN
363L00000X
Nurse Practitioner
3008212
KY
363L00000X
Nurse Practitioner
71000024
IN
363L00000X
Nurse Practitioner
Primary
71000024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359300A
—
IN
01
—
50005027
RR MEDICARE
IN
05
—
7100267480
—
KY
Enumeration date
10/20/2005
Last updated
09/03/2014
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