Provider Demographics
NPI:1154323186
Name:SANDERSON, NANCY HARRELL (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:HARRELL
Last Name:SANDERSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 CORRY RD
Mailing Address - Street 2:
Mailing Address - City:UNION POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30669-2849
Mailing Address - Country:US
Mailing Address - Phone:706-486-2848
Mailing Address - Fax:706-486-2981
Practice Address - Street 1:1180 CORRY RD
Practice Address - Street 2:
Practice Address - City:UNION POINT
Practice Address - State:GA
Practice Address - Zip Code:30669-2849
Practice Address - Country:US
Practice Address - Phone:706-486-2848
Practice Address - Fax:706-486-2981
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN037457163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse