Provider Demographics
NPI:1891929071
Name:SANDLUND, STEPHEN KRISTOFER (FNP)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:KRISTOFER
Last Name:SANDLUND
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 MILLENNIUM DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1194
Mailing Address - Country:US
Mailing Address - Phone:740-221-4588
Mailing Address - Fax:
Practice Address - Street 1:4623 MILLENNIUM DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1194
Practice Address - Country:US
Practice Address - Phone:740-221-4588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily