Provider Demographics
NPI:1841220266
Name:WHEATON, SANDRA JEAN (APNC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JEAN
Last Name:WHEATON
Suffix:
Gender:F
Credentials:APNC
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Other - Credentials:
Mailing Address - Street 1:3477 FOREST VIEW CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-5310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2367
Practice Address - Country:US
Practice Address - Phone:360-414-7960
Practice Address - Fax:360-414-2750
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVAPN00547363LF0000X
WAAP60914133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily