Individual
MRS. AMY BLAINE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1935 LAKELAND DR STE 900, JACKSON, MS 39216-5028
(601) 718-2468
Mailing address
1935 LAKELAND DR STE 900, JACKSON, MS 39216-5028
(601) 718-2468
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
812168
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02191972
—
MS
Enumeration date
05/07/2021
Last updated
05/11/2026
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