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General NPI Number Information
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NPI Number | 1245380021
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Entity Type | Individual
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Provider Name | SANDRA S. IRWIN RNFA
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 202 MILITARY TRAIL #303
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City | JUPITER
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State | FL
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Zip | 33458
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Country | US
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Telephone | 561-427-0860
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Fax | 561-427-0870
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Provider Business Mailing Address
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Address Line | 2055 MILITARY TRL #303
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City | JUPITER
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State | FL
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Zip | 33458-7801
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Country | US
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Telephone | 567-427-0860
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Fax | 561-427-0870
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN1483552
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License Number State | FL
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