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1861357691

NPI Code Detail

MEDICARE: JESSE SANDERS

MEDICARE: JESSE SANDERS

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	163W00000X	Registered Nurse	265112	SC

General Provider Information

NPI Number	:	1861357691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE SANDERS

Provider Business Mailing Address
First Line	:	406 BIG ROCK LAKE RD
Second Line	:
City	:	PICKENS
State	:	SC
Zip	:	29671-9284
Country	:	US
Telephone Number	:	602-717-4953
Fax Number	:

Provider Business Practice Location Address
First Line	:	1898 FORT RD
Second Line	:
City	:	SHERIDAN
State	:	WY
Zip	:	82801-8320
Country	:	US
Telephone Number	:	602-717-4953
Fax Number	:

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

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	12/23/2025

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Directions to “ JESSE SANDERS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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