Provider Demographics
NPI:1184049595
Name:KINDIG OGUZLU, SANDI K (FNPBC-APNP)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:K
Last Name:KINDIG OGUZLU
Suffix:
Gender:F
Credentials:FNPBC-APNP
Other - Prefix:
Other - First Name:SANDI
Other - Middle Name:K
Other - Last Name:OGUZLU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNPBC-APNP
Mailing Address - Street 1:PO BOX 5481
Mailing Address - Street 2:MADISON
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-0481
Mailing Address - Country:US
Mailing Address - Phone:608-298-8441
Mailing Address - Fax:
Practice Address - Street 1:2949 N MAYFAIR RD
Practice Address - Street 2:WAUWATOSA
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53222-4304
Practice Address - Country:US
Practice Address - Phone:414-391-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5674-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400145143Medicare Oscar/Certification