Provider Demographics
NPI:1598839847
Name:BABCOCK, SANDRA L (RN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:BABCOCK
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:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:NOTI
Mailing Address - State:OR
Mailing Address - Zip Code:97461
Mailing Address - Country:US
Mailing Address - Phone:541-935-3803
Mailing Address - Fax:541-935-6278
Practice Address - Street 1:89288 KNIGHT RD
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:OR
Practice Address - Zip Code:97437
Practice Address - Country:US
Practice Address - Phone:541-935-3803
Practice Address - Fax:541-935-6278
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health