Provider Demographics
NPI:1356448724
Name:CRANDALL, SANDRA G (NP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:G
Last Name:CRANDALL
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1382 NEWTOWN LANGHORNE RD
Mailing Address - Street 2:PENNSWOOD VILLAGE CCRC
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2401
Mailing Address - Country:US
Mailing Address - Phone:215-504-1152
Mailing Address - Fax:215-579-6809
Practice Address - Street 1:1382 NEWTOWN LANGHORNE RD
Practice Address - Street 2:PENNSWOOD VILLAGE CCRC
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2401
Practice Address - Country:US
Practice Address - Phone:215-504-1152
Practice Address - Fax:215-579-6809
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PATP001228B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS61718Medicare UPIN