Provider Demographics
NPI:1013196674
Name:SANDLIN, DANA L (RN)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:L
Last Name:SANDLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20740 S ELLSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-9058
Mailing Address - Country:US
Mailing Address - Phone:480-987-7424
Mailing Address - Fax:
Practice Address - Street 1:20740 S ELLSWORTH RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-9058
Practice Address - Country:US
Practice Address - Phone:480-987-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN069606163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse