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NPI Code Detail

MEDICARE: KERRY A SANDER NURSE PRACTITIONER

MEDICARE:   KERRY A SANDER  NURSE PRACTITIONER
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
1363LP2300XPrimary Care Nurse Practitioner53-75518-082KS

General Provider Information

NPI Number : 1588947147
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY A SANDER NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 16191 S BROOKFIELD ST
Second Line :
City : OLATHE
State : KS
Zip : 66062-3927
Country : US
Telephone Number : 913-634-2398
Fax Number :
Provider Business Practice Location Address
First Line : 7500 W 160TH ST
Second Line :
City : STILWELL
State : KS
Zip : 66085-8100
Country : US
Telephone Number : 913-814-8000
Fax Number : 913-948-5206
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2011
Last Update Date : 10/03/2024

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Directions to “ KERRY A SANDER NURSE PRACTITIONER” Practice Location

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