Doctor Name: | MRS. JOY SANDY |
NPI Number: | 1013382357 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4704208228 |
Business Practice Address: | 8424 Parkside Dr Grand Blanc, MI - 484397454 |
Business Phone Number: | 8106255072 |
Business Fax Number: | |
Mailing Address: | 8424 Parkside Dr, GRAND BLANC |
State: | MI |
Postal Code: | 484397454 |
Phone Number: | 8106255072 |
Fax Number: | |
NPI Enumeration Date: | 12/12/2015 |
NPI Last Update Date: | 12/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 4704208228 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |