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General NPI Number Information
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NPI Number | 1154308054
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Entity Type | Individual
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Provider Name | SANDRA WIITA
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Gender | Female
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 4538 HIGHLAND RD
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City | MINNETONKA
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State | MN
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Zip | 55345-3621
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Country | US
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Telephone | 952-412-4847
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Fax |
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Provider Business Mailing Address
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Address Line | 4538 HIGHLAND RD
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City | MINNETONKA
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State | MN
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Zip | 55345-3621
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Country | US
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Telephone | 952-412-4847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 51980-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01072488A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | P9989
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29912
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.122172
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 268105-1
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2013-0891
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License Number State | NM
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 27356
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License Number State | NE
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301102453
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.206767
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License Number State | LA
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Taxonomy #11
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.131953
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License Number State | IL
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Taxonomy #12
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 051623
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License Number State | CT
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Taxonomy #13
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2013011071
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License Number State | MO
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Taxonomy #14
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 42376
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License Number State | MN
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