Doctor Name: | JAMES LAWRENCE SALL |
NPI Number: | 1457341968 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | AP1188 |
Business Practice Address: | 550 Pope Ave Fort Leavenworth, KS - 660272332 |
Business Phone Number: | 9136846671 |
Business Fax Number: | |
Mailing Address: | 710 Rock Creek Dr, LANSING |
State: | KS |
Postal Code: | 660436273 |
Phone Number: | 9136846671 |
Fax Number: | 9136846128 |
NPI Enumeration Date: | 10/26/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP1188 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |