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General NPI Number Information
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NPI Number | 1356799282
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Entity Type | Individual
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Provider Name | SANDRA AFRIFAH FNP
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Gender | Female
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 17805 HALSTED ST
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City | HOMEWOOD
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State | IL
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Zip | 60430-2011
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Country | US
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Telephone | 773-834-6254
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Fax | 773-834-6259
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Provider Business Mailing Address
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Address Line | PO BOX 751649
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City | CHARLOTTE
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State | NC
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Zip | 28275-1649
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Country | US
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Telephone | 843-789-1620
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Fax | 843-724-2440
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP016145
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 873917
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277.0022981
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F353245-01
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61518975
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 20073
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License Number State | SC
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