Provider Demographics
NPI:1518660471
Name:SANDER, JAMIE MICHELLE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MICHELLE
Last Name:SANDER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 WATERFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2869
Mailing Address - Country:US
Mailing Address - Phone:812-465-6202
Mailing Address - Fax:
Practice Address - Street 1:6211 WATERFORD BLVD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2869
Practice Address - Country:US
Practice Address - Phone:812-465-6202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28168655A163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology