Healthcare Provider Details

I. General information

NPI: 1184989246
Provider Name (Legal Business Name): JAMES BOYD SANDLER FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 MAPLEWOOD COMMONS DR
SAINT LOUIS MO
63143-1003
US

IV. Provider business mailing address

2015 MAPLEWOOD COMMONS DR
SAINT LOUIS MO
63143-1003
US

V. Phone/Fax

Practice location:
  • Phone: 314-293-4023
  • Fax: 314-293-4285
Mailing address:
  • Phone: 314-293-4023
  • Fax: 314-293-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number820337
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number184418
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2012035668
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: