Provider Demographics
NPI:1073947511
Name:DRY, SANDRA JARDINE (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:JARDINE
Last Name:DRY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3641 ROLLING HILLS LN
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-4781
Mailing Address - Country:US
Mailing Address - Phone:407-256-1599
Mailing Address - Fax:
Practice Address - Street 1:3641 ROLLING HILLS LN
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-4781
Practice Address - Country:US
Practice Address - Phone:407-256-1599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-31
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9266766163WL0100X
FL11136027163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant