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General NPI Number Information
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NPI Number | 1518900596
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Entity Type | Individual
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Provider Name | SANDRA BOARDMAN HARPER NP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 506 MEDICAL CENTER BLVD STE. 304
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City | CONROE
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State | TX
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Zip | 77304-2826
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Country | US
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Telephone | 888-624-6882
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Fax | 888-395-9138
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Provider Business Mailing Address
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Address Line | 3500 HILLCREST DR STE. 1
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City | WACO
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State | TX
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Zip | 76708-3157
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Country | US
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Telephone | 888-624-6882
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Fax | 888-395-9138
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 595011
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License Number State | TX
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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 | AP109254
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License Number State | TX
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