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Individual

SANDRA E MCGRATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1720 E REELFOOT AVE, STE 202 A, UNION CITY, TN 38261-6047
(731) 885-3866
(731) 885-3868
Mailing address
1720 E REELFOOT AVE, STE 202 A, UNION CITY, TN 38261-6047
(731) 885-3866
(731) 885-3868

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1607
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150373
TN
01
200448096
FEDRERAL TAX ID
TN
01
4075871
BLUE CROSS BLUE SHIELD
TN
05
9523
TN
Enumeration date
04/12/2006
Last updated
12/04/2009
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