Provider Demographics
NPI:1467461137
Name:DEAN, SANDY (APRN)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:615-425-4201
Practice Address - Street 1:2011 NASHVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3162
Practice Address - Country:US
Practice Address - Phone:615-575-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011402363LF0000X
TN7266363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN36487001Medicare PIN
TNQ36530Medicare UPIN