=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881568194
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA SANDERS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2025
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1118 BURLINGTON ST
-----------------------------------------------------
City | HOLDREGE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68949-1705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-995-3760
-----------------------------------------------------
Fax | 612-725-1054
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1105 GARFIELD ST
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68850-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP2201X
-----------------------------------------------------
Taxonomy Name | Ambulatory Care Registered Nurse
-----------------------------------------------------
License Number | 42877
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------