Healthcare Provider Details

I. General information

NPI: 1306792288
Provider Name (Legal Business Name): EMILIE ANNE SANDERS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4370 W MAIN ST
DOTHAN AL
36305-4000
US

IV. Provider business mailing address

209 KELSO LN
DOTHAN AL
36305-1192
US

V. Phone/Fax

Practice location:
  • Phone: 334-699-7900
  • Fax:
Mailing address:
  • Phone: 850-904-6508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-145489
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: