MEDICARE: MS. EMILIE ANNE SANDERS FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1-145489	AL

General Provider Information

NPI Number	:	1306792288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILIE ANNE SANDERS FNP-C

Provider Business Mailing Address
First Line	:	209 KELSO LN
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36305-1192
Country	:	US
Telephone Number	:	850-904-6508
Fax Number	:

Provider Business Practice Location Address
First Line	:	4370 W MAIN ST
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36305-4000
Country	:	US
Telephone Number	:	334-699-7900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	06/11/2026

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