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NPI 1366648156

NPI 1366648156 : SANDRA WEST REGISTERED NURSE : FAIRBURN, GA

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General NPI Number Information
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    NPI Number           |    1366648156
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    Entity Type          |    Individual 
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    Provider Name        |    SANDRA WEST REGISTERED NURSE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/27/2007
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    Last Update Date     |    10/09/2025
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Provider Practice Location Address
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    Address Line         |    515 WHIMSICAL CT 
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    City                 |    FAIRBURN
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    State                |    GA
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    Zip                  |    30213-4325
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    Country              |    US
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    Telephone            |    404-321-6111
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    515 WHIMSICAL CT 
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    City                 |    FAIRBURN
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    State                |    GA
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    Zip                  |    30213-4325
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    Country              |    US
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    Telephone            |    404-321-6111
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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        |    364SA2200X
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    Taxonomy Name        |    Adult Health Clinical Nurse Specialist
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    License Number       |    118311
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    License Number State |    GA
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Taxonomy #2
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    118311
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    License Number State |    GA
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