MEDICARE: SUZANNE MARIE SANDHU BSN, MSN, APRN-BC

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	53-80123-061	KS
2	363L00000X	Nurse Practitioner	53-80123-061	KS
3	363LA2200X	Adult Health Nurse Practitioner	2012011745	MO
4	363L00000X	Nurse Practitioner	2012011745	MO

General Provider Information

NPI Number	:	1710245766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE MARIE SANDHU BSN, MSN, APRN-BC

Provider Business Mailing Address
First Line	:	5101 COLLEGE BLVD
Second Line	:
City	:	LEAWOOD
State	:	KS
Zip	:	66211-1614
Country	:	US
Telephone Number	:	913-721-3387
Fax Number	:

Provider Business Practice Location Address
First Line	:	290 NE TUDOR RD
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-5696
Country	:	US
Telephone Number	:	816-524-5522
Fax Number	:	816-875-2597

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

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	02/03/2026

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