Provider Demographics
NPI:1437421369
Name:SAUNDERS, NICHOLAS LEE (RN)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:LEE
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 ROCKY BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2929
Mailing Address - Country:US
Mailing Address - Phone:434-238-5942
Mailing Address - Fax:
Practice Address - Street 1:1970 ROANOKE BOULEVARD
Practice Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6478
Practice Address - Country:US
Practice Address - Phone:540-224-1983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001160760163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical