Provider Demographics
NPI:1972671220
Name:SANDERS, BARBARA B (CRNP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:B
Last Name:SANDERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:1400 SPRING STREET; SUITE 200
Practice Address - Street 2:TEENS AND YOUNG ADULT HEALTH CONNEC
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-565-0714
Practice Address - Fax:301-565-0916
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR056359363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P36313Medicare UPIN
014471K92Medicare ID - Type Unspecified