Provider Demographics
NPI:1477839934
Name:NEMCEK, SANDRA MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MARIE
Last Name:NEMCEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2693 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MAINE
Mailing Address - State:NY
Mailing Address - Zip Code:13802
Mailing Address - Country:US
Mailing Address - Phone:607-862-5374
Mailing Address - Fax:607-862-3323
Practice Address - Street 1:2693 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MAINE
Practice Address - State:NY
Practice Address - Zip Code:13802
Practice Address - Country:US
Practice Address - Phone:607-862-5374
Practice Address - Fax:607-862-3323
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285960-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool