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NPI Code Detail

MEDICARE: CHRISTINE SANFORD NP

MEDICARE: CHRISTINE SANFORD NP
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
1363LP0200XPediatric Nurse Practitioner300134NC

Other Identifiers

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

General Provider Information

NPI Number : 1538161617
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE SANFORD NP
Provider Business Mailing Address
First Line : 2131 S 17TH ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7407
Country : US
Telephone Number : 910-667-3985
Fax Number : 910-667-6495
Provider Business Practice Location Address
First Line : 2131 S 17TH ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7407
Country : US
Telephone Number : 910-667-3985
Fax Number : 910-667-6495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 10/31/2012

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