| Doctor Name: | SANDRA JEAN VANDYKE |
| NPI Number: | 1669545398 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 0024164146 |
| Business Practice Address: | 18765 Riverside Dr Vansant, VA - 24656 |
| Business Phone Number: | 2769352880 |
| Business Fax Number: | 2769352889 |
| Mailing Address: | 1804 Old Vandyke Hollow Rd, OAKWOOD |
| State: | VA |
| Postal Code: | 246318490 |
| Phone Number: | 2764984103 |
| Fax Number: | |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 03/30/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024164146 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |