Provider Demographics
NPI:1538475421
Name:SANDIFORD, JANICE ELIZABETH (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:ELIZABETH
Last Name:SANDIFORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1835 SAVOY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1072
Mailing Address - Country:US
Mailing Address - Phone:770-981-5431
Mailing Address - Fax:770-495-2307
Practice Address - Street 1:5700 HILLANDALE DR STE 250
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4120
Practice Address - Country:US
Practice Address - Phone:770-981-5431
Practice Address - Fax:770-981-5515
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN120356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003101232CMedicaid
GA202I503406OtherMEDICARE PTAN