Individual
MRS. SANDRA K OETTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704185806
MI
363L00000X
Nurse Practitioner
Primary
COA 17191 NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129568
—
MI
05
—
0129568
—
OH
05
—
1992034458
—
MI
01
—
H429260
MEDICARE PIN
OH
01
—
MI4068021
MEDICARE
MI
Enumeration date
12/11/2009
Last updated
06/06/2025
Update your record
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