Healthcare Provider Details

I. General information

NPI: 1205229697
Provider Name (Legal Business Name): ANN GEE SANDERSON NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2015
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

332 WINDMILL DR
WINTERVILLE NC
28590-6601
US

V. Phone/Fax

Practice location:
  • Phone: 252-847-4378
  • Fax:
Mailing address:
  • Phone: 252-341-7869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5007516
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number5007516
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: