MEDICARE: INDIA KESHUNA 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
1	363L00000X	Nurse Practitioner	907458	MS
2	363LF0000X	Family Nurse Practitioner	907458	MS

General Provider Information

NPI Number	:	1972459048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INDIA KESHUNA SANDERS

Provider Business Mailing Address
First Line	:	85 DRAKE CIR
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-8674
Country	:	US
Telephone Number	:	662-769-9914
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 DRAKE CIR
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-8674
Country	:	US
Telephone Number	:	662-769-9914
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “ INDIA KESHUNA SANDERS ” Practice Location

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