Individual
SANDRA STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 SPARTA ST, TENN DEPT OF HEALTH, MC MINNVILLE, TN 37110-1301
(931) 473-8468
Mailing address
768 WILLIE JARVIS RD, SPARTA, TN 38583-5645
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
84392
TN
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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