Provider Demographics
NPI:1346729639
Name:DUNKLEY, SANDRA LMAIDENEE (LVN)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LMAIDENEE
Last Name:DUNKLEY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19801 COUNTY ROAD 4130
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-7156
Mailing Address - Country:US
Mailing Address - Phone:773-414-3080
Mailing Address - Fax:
Practice Address - Street 1:19801 COUNTY ROAD 4130
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-7156
Practice Address - Country:US
Practice Address - Phone:773-414-3080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26379164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse