Individual
CONNIE SANDERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
600 SOUTH PINE STREET, DERIDDER, LA 70634-0730
(337) 462-7100
Mailing address
600 SOUTH PINE STREET, DERIDDER, LA 70634-0730
(337) 462-7100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RNO97669
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1712558
—
LA
Enumeration date
07/12/2006
Last updated
03/12/2009
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