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General NPI Number Information
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NPI Number | 1639513948
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Entity Type | Individual
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Provider Name | SANDRA L ANDERSON ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 1168 E CUTLAR XING
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City | LELAND
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State | NC
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Zip | 28451-6484
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Country | US
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Telephone | 910-332-3800
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Fax | 910-251-0421
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Provider Business Mailing Address
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Address Line | 11350 MCCORMICK RD EXECUTIVE PLAZA 1, SUITE 501
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City | HUNT VALLEY
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State | MD
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Zip | 21031
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Country | US
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Telephone | 410-329-1071
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Fax | 410-329-1054
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5336
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5012667
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License Number State | NC
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