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Individual

SANDRA L IVERSON

Active
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Individual

SANDRA L IVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R 063381-7
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025A2IV
BCBS
MN
01
1043948
PREFERRED ONE
01
104736
U CARE
MN
01
12-00987
MEDICA-CHOICE
01
12-09026
MEDICA-PRIMARY
01
1576851
AMERICAS PPO/ARAZ
01
207209
FAIRVIEW
MN
05
4305613
MT
05
43929100
WI
05
941742700
MN
01
A520
CHAMPUS
01
HP21983
HEALTH PARTNERS
MN
01
P00014192
RAILROAD MEDICARE
Enumeration date
09/26/2006
Last updated
10/03/2012
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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