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General NPI Number Information
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NPI Number | 1710842232
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Entity Type | Organization
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Legal Business Name | SANDERSON HEALTH CENTER LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 315 W 9TH ST
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City | WELEETKA
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State | OK
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Zip | 74880-8117
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Country | US
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Telephone | 405-786-2248
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Fax | 405-786-2006
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Provider Business Mailing Address
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Address Line | PO BOX 276
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City | WELEETKA
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State | OK
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Zip | 74880-0276
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Country | US
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Telephone | 405-786-2248
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Fax | 405-786-2006
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | KIMBER MARIE SANDERSON
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Credential | APRN-CNP
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Telephone | 405-584-1071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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