Healthcare Provider Details

I. General information

NPI: 1720383094
Provider Name (Legal Business Name): SANDRA LEE THORNTON DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANDRA LEE THORNTON DNP

II. Dates (important events)

Enumeration Date: 01/18/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 KENSINGTON SQUARE CT
MURFREESBORO TN
37130-6939
US

IV. Provider business mailing address

2620 NEW SALEM HWY APT D208
MURFREESBORO TN
37128-4312
US

V. Phone/Fax

Practice location:
  • Phone: 615-801-4696
  • Fax:
Mailing address:
  • Phone: 508-269-5119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number278565
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: