Provider Demographics
NPI:1740762426
Name:HOPE, SANDRA RENEE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:RENEE
Last Name:HOPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:RENEE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:5000 BLACKMORE RD
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-3345
Mailing Address - Country:US
Mailing Address - Phone:307-233-6000
Mailing Address - Fax:307-236-6089
Practice Address - Street 1:2025 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-2052
Practice Address - Country:US
Practice Address - Phone:307-309-5915
Practice Address - Fax:307-372-9959
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-116206-111163WP0200X
MO2005040254163WP0200X
MO2018036806363LF0000X
WY48934363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0200XNursing Service ProvidersRegistered NursePediatrics