Individual
ANNIE NICOLE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3700 SOUTHERN BLVD STE 201, KETTERING, OH 45429-1265
(855) 500-2873
(937) 281-3805
Mailing address
3700 SOUTHERN BLVD STE 201, KETTERING, OH 45429-1265
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-13772
NC
363A00000X
Physician Assistant
030688
NY
363A00000X
Physician Assistant
Primary
50.010230RX
OH
Other
Enumeration date
09/20/2023
Last updated
06/23/2026
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