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General NPI Number Information
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NPI Number | 1962121095
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Entity Type | Individual
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Provider Name | STEVEY ELYSE SANDERS APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 3445 BANNERMAN RD STE 100
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City | TALLAHASSEE
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State | FL
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Zip | 32312-7053
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Country | US
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Telephone | 850-894-2401
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Fax |
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Provider Business Mailing Address
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Address Line | 3445 BANNERMAN RD STE 100
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City | TALLAHASSEE
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State | FL
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Zip | 32312-7053
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Country | US
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Telephone | 850-894-2401
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Fax | 850-894-2779
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F07221856
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11022442
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License Number State | FL
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