Provider Demographics
NPI:1265878870
Name:SANDS, PATRICK
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:SANDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 PINE LAKE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6009
Mailing Address - Country:US
Mailing Address - Phone:402-261-4017
Mailing Address - Fax:402-261-9185
Practice Address - Street 1:2935 PINE LAKE RD.
Practice Address - Street 2:SUITE F
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-261-4017
Practice Address - Fax:402-261-9185
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator