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General NPI Number Information
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NPI Number | 1306113931
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Entity Type | Individual
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Provider Name | SALLY ANN SEWELL CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 1102 SAINT MARYS RD RM 1204
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City | JUNCTION CITY
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State | KS
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Zip | 66441-4139
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Country | US
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Telephone | 785-762-3416
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Fax | 785-762-3516
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Provider Business Mailing Address
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Address Line | 1102 SAINT MARYS RD RM 1204
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City | JUNCTION CITY
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State | KS
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Zip | 66441-4139
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Country | US
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Telephone | 785-762-3416
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Fax | 785-762-3516
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 557060
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License Number State | KS
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