Provider Demographics
NPI:1265028765
Name:PINNELL, SANDRA SUE
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:SUE
Last Name:PINNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 STEVENS RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-7093
Mailing Address - Country:US
Mailing Address - Phone:304-672-6877
Mailing Address - Fax:
Practice Address - Street 1:153 STEVENS RD
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-7093
Practice Address - Country:US
Practice Address - Phone:304-672-6877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide