Provider Demographics
NPI:1235856972
Name:SANCHEZ, SANDRA MARILU (FNP-C)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARILU
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 DAYVIEW LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-9520
Mailing Address - Country:US
Mailing Address - Phone:706-308-8475
Mailing Address - Fax:
Practice Address - Street 1:5836 BUFORD HWY STE C
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-2581
Practice Address - Country:US
Practice Address - Phone:770-734-9920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN241680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty