Individual
MS. SANDRA GAIL TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
619 N 30TH ST, PADUCAH, KY 42001-4047
(270) 444-8183
(270) 444-8147
Mailing address
619 N 30TH ST, PADUCAH, KY 42001-4047
(270) 444-8183
(270) 444-8147
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1040966
KY
363L00000X
Nurse Practitioner
Primary
3006232
KY
364S00000X
Clinical Nurse Specialist
3006232
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000740558
ANTHEM
KY
05
—
7100170370
—
KY
05
—
7100190170
—
KY
Enumeration date
02/18/2010
Last updated
05/31/2016
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