Individual
STACY ANN SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1655 BERNARDIN AVE STE 220, COLUMBIA, SC 29204-2044
(843) 792-1414
Mailing address
PO BOX 23321, NEW YORK, NY 10087-3321
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN61073477
WA
363LA2100X
Acute Care Nurse Practitioner
Primary
27220
SC
363LA2100X
Acute Care Nurse Practitioner
AP61105297
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679187603
—
WA
Enumeration date
09/08/2020
Last updated
12/24/2025
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