Provider Demographics
NPI:1821261967
Name:SANDERS-CLEARY, ARDENIA (RN-BSN)
Entity Type:Individual
Prefix:MRS
First Name:ARDENIA
Middle Name:
Last Name:SANDERS-CLEARY
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6880 KENTUCKY 3520
Mailing Address - Street 2:
Mailing Address - City:WEST PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42086-9531
Mailing Address - Country:US
Mailing Address - Phone:270-744-9717
Mailing Address - Fax:
Practice Address - Street 1:6880 KENTUCKY 3520
Practice Address - Street 2:
Practice Address - City:WEST PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42086-9531
Practice Address - Country:US
Practice Address - Phone:270-744-9717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1062783282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital