Individual
AMY MELINDA SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
789 EASTERN BYP, SUITE 14, RICHMOND, KY 40475-2415
(859) 625-0900
(859) 625-0995
Mailing address
4071 TATES CREEK CENTRE DR, SUITE 202, LEXINGTON, KY 40517-3062
(859) 625-0900
(859) 625-0995
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1112888
KY
363L00000X
Nurse Practitioner
3006515
KY
363LF0000X
Family Nurse Practitioner
Primary
3006515
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7100136150
MEDICAID
KY
Enumeration date
08/02/2010
Last updated
09/21/2017
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