Healthcare Provider Details

I. General information

NPI: 1174692305
Provider Name (Legal Business Name): SANDRA LEE-HOEFS ANDERSON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 VANDALIA ST
SAINT PAUL MN
55114-1312
US

IV. Provider business mailing address

PO BOX 46341
EDEN PRAIRIE MN
55344-3041
US

V. Phone/Fax

Practice location:
  • Phone: 651-696-5672
  • Fax: 651-696-5543
Mailing address:
  • Phone: 952-944-2885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR070602-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: