Provider Demographics
NPI:1033665419
Name:SANDERS, JEANNEE L (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JEANNEE
Middle Name:L
Last Name:SANDERS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17230 JACKSON CREEK PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-7305
Mailing Address - Country:US
Mailing Address - Phone:719-776-4740
Mailing Address - Fax:719-776-4750
Practice Address - Street 1:17230 JACKSON CREEK PKWY STE 260
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-7305
Practice Address - Country:US
Practice Address - Phone:719-776-4740
Practice Address - Fax:719-776-4750
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.09927-13NP363L00000X, 363LF0000X
CO0125865163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic