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General NPI Number Information
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NPI Number | 1679352371
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Entity Type | Individual
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Provider Name | SANDY SAMIR-HADDAD DUKE MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 5415 CARDINAL SQUARE BLVD
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City | SAGINAW
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State | MI
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Zip | 48604-8200
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Country | US
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Telephone | 989-790-4855
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Fax |
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Provider Business Mailing Address
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Address Line | 3065 WILDWOOD DR
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City | SAGINAW
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State | MI
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Zip | 48603-1638
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Country | US
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Telephone | 989-493-4534
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704341490
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License Number State | MI
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