Provider Demographics
NPI:1922101518
Name:ATTEBERY, SANDRA RAYE (RNC MSN CNSBC CWON C)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:RAYE
Last Name:ATTEBERY
Suffix:
Gender:F
Credentials:RNC MSN CNSBC CWON C
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Other - First Name:
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Mailing Address - Street 1:1011 HONOR HEIGHTS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-1399
Mailing Address - Country:US
Mailing Address - Phone:918-683-3261
Mailing Address - Fax:918-680-3879
Practice Address - Street 1:1011 HONOR HEIGHTS DRIVE
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-1399
Practice Address - Country:US
Practice Address - Phone:918-683-3261
Practice Address - Fax:918-680-3879
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKR0025966364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist