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General NPI Number Information
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NPI Number | 1952387854
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Entity Type | Individual
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Provider Name | LETICIA SANDROCK NP
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Gender | Female
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | WIESBADEN ARMY HEALTH CLINIC UNIT 29623
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City | APO
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State | AE
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Zip | 09096
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Country | DE
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Telephone | 496117055332
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Fax |
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Provider Business Mailing Address
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Address Line | LANDSTUHL REGIONAL MEDICAL CENTER ATTN: MCEUL-DCCS (CREDENTIALS), CMR 402
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City | APO
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State | AE
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Zip | 09180
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Country | DE
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Telephone | 496371868839
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Fax | 6133
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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 | 125932
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License Number State | CO
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