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Individual

SANDRA M HERDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
100 ROSS BLVD SUITE 2A, DODGE CITY, KS 67801
(620) 227-3141
(620) 227-8095
Mailing address
100 ROSS BLVD SUITE 2A, DODGE CITY, KS 67801
(620) 227-3141
(620) 227-8095

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-44816
KS
363LF0000X
Family Nurse Practitioner
1474105061
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111190002
MEDICARE PTAN
KS
Enumeration date
10/01/2008
Last updated
07/21/2022
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