Provider Demographics
NPI:1437440336
Name:CORD, SANDRA K (NP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:CORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5150 SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-2601
Mailing Address - Country:US
Mailing Address - Phone:317-782-1577
Mailing Address - Fax:888-392-3210
Practice Address - Street 1:5150 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-2601
Practice Address - Country:US
Practice Address - Phone:317-782-1577
Practice Address - Fax:888-392-3210
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28102000A163W00000X
IN71003596A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse