Provider Demographics
NPI:1245380021
Name:IRWIN, SANDRA S (RNFA)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:S
Last Name:IRWIN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 MILITARY TRL
Mailing Address - Street 2:#303
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7801
Mailing Address - Country:US
Mailing Address - Phone:567-427-0860
Mailing Address - Fax:561-427-0870
Practice Address - Street 1:202 MILITARY TRAIL
Practice Address - Street 2:#303
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-427-0860
Practice Address - Fax:561-427-0870
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1483552163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant