| Doctor Name: | SANDRA SMITH TRUMBACH |
| NPI Number: | 1174941553 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NNP BC |
| License Number: | AP03208 |
| Business Practice Address: | 149 Drinkwater Rd Bay St Louis, MS - 395201658 |
| Business Phone Number: | 2284678600 |
| Business Fax Number: | |
| Mailing Address: | 149 Drinkwater Rd, BAY ST LOUIS |
| State: | MS |
| Postal Code: | 395201658 |
| Phone Number: | 2284678600 |
| Fax Number: | |
| NPI Enumeration Date: | 04/02/2014 |
| NPI Last Update Date: | 04/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0005X |
| License Number: | AP03208 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal, Critical Care |
| Taxonomy Definition: | |