Provider Demographics
NPI:1306866546
Name:SAUNDERS, NAN L (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NAN
Middle Name:L
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 FAIRCHILD CT
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4321
Mailing Address - Country:US
Mailing Address - Phone:530-666-1631
Mailing Address - Fax:
Practice Address - Street 1:1207 FAIRCHILD CT
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4321
Practice Address - Country:US
Practice Address - Phone:530-666-1631
Practice Address - Fax:530-666-3691
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN344356163W00000X
CANP9844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA500004020OtherRR MEDICARE
CA500004020OtherRR MEDICARE
CAZZZ17405ZMedicare ID - Type Unspecified
S93521Medicare UPIN