Provider Demographics
NPI:1639721152
Name:HOERR, SANDRA LEE (DNP, CPNP)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LEE
Last Name:HOERR
Suffix:
Gender:F
Credentials:DNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S ATWOOD ROAD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014
Mailing Address - Country:US
Mailing Address - Phone:410-838-9555
Mailing Address - Fax:410-836-5056
Practice Address - Street 1:602 S ATWOOD ROAD
Practice Address - Street 2:SUITE 104
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014
Practice Address - Country:US
Practice Address - Phone:410-838-9555
Practice Address - Fax:410-836-5056
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR198025363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR198025OtherNP LICENSE
MD199LI11QMedicaid