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NPI Code Detail

MEDICARE: JESSICA SANDERS

MEDICARE: JESSICA SANDERS
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
1171M00000XCase Manager/Care Coordinator261QD1600XAR

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 : 1740730951
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA SANDERS
Provider Business Mailing Address
First Line : 3434 ONE PL
Second Line :
City : JONESBORO
State : AR
Zip : 72404-9335
Country : US
Telephone Number : 870-240-0444
Fax Number : 870-240-0466
Provider Business Practice Location Address
First Line : 6263 HIGHWAY 49 S
Second Line :
City : PARAGOULD
State : AR
Zip : 72450-6093
Country : US
Telephone Number : 870-240-0444
Fax Number : 870-240-0466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2016
Last Update Date : 10/12/2016

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Directions to “ JESSICA SANDERS ” Practice Location

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