Provider Demographics
NPI:1679185599
Name:SANDMAN, RITA MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:MARIE
Last Name:SANDMAN
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 1:319 S FAWCETT ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51103-4611
Mailing Address - Country:US
Mailing Address - Phone:712-490-4051
Mailing Address - Fax:402-494-1968
Practice Address - Street 1:820 E 29TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3344
Practice Address - Country:US
Practice Address - Phone:402-494-1662
Practice Address - Fax:402-494-1968
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA071184163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool