Provider Demographics
NPI:1275106692
Name:SANDERS, STACY ANN
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:ANN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 SAVANNAH TER SE APT 13
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2069
Mailing Address - Country:US
Mailing Address - Phone:202-678-3569
Mailing Address - Fax:
Practice Address - Street 1:2220 SAVANNAH TER SE APT 13
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2069
Practice Address - Country:US
Practice Address - Phone:202-678-3596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide