Healthcare Provider Details

I. General information

NPI: 1114521218
Provider Name (Legal Business Name): EMILY ANNE SANDS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY ANNE SPRINGER PHARMD

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E PARK DR
ALBION IN
46701-1438
US

IV. Provider business mailing address

6119 STELLHORN RD
FORT WAYNE IN
46815-5357
US

V. Phone/Fax

Practice location:
  • Phone: 574-385-3129
  • Fax:
Mailing address:
  • Phone: 260-485-4697
  • Fax: 260-247-7172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26029007A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number28277462A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: