Provider Demographics
NPI:1528403383
Name:SANDERS, CAROL H (RN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:H
Last Name:SANDERS
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 1:6671 SAINT ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2125
Mailing Address - Country:US
Mailing Address - Phone:803-476-3009
Mailing Address - Fax:803-476-3020
Practice Address - Street 1:6671 SAINT ANDREWS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-2125
Practice Address - Country:US
Practice Address - Phone:803-476-3009
Practice Address - Fax:803-476-3020
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23396163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse