Individual
LISA SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
322 W SOUTH ST, UNION, SC 29379
(864) 429-8029
(864) 429-3515
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18641
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2693
—
SC
01
—
SC26745019
MEDICARE PIN
SC
01
—
SC26746067
MEDICARE PIN
SC
01
—
SC26746121
MEDICARE PIN
SC
01
—
SC2674H888
MEDICARE PIN
SC
01
—
SC2674J577
MEDICARE PIN
SC
Enumeration date
01/13/2014
Last updated
03/12/2020
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