MEDICARE: SANDRA BIELANSKI CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	10889	OH
2	363LA2200X	Adult Health Nurse Practitioner	APRN11026320	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104155571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA BIELANSKI CNP

Provider Business Mailing Address
First Line	:	8227 KENSINGTON SQ
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4401
Country	:	US
Telephone Number	:	440-376-6570
Fax Number	:

Provider Business Practice Location Address
First Line	:	8227 KENSINGTON SQ
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4401
Country	:	US
Telephone Number	:	440-376-6570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2009
Last Update Date	:	09/26/2023

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