Provider Demographics
NPI:1669564332
Name:STANEART, SANDRA K (ARNP)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:K
Last Name:STANEART
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 SOUTH MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067
Mailing Address - Country:US
Mailing Address - Phone:785-242-3891
Mailing Address - Fax:785-242-3891
Practice Address - Street 1:1302 SOUTH MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067
Practice Address - Country:US
Practice Address - Phone:785-242-3891
Practice Address - Fax:785-242-3891
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5344213363L00000X
KS163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSR31006Medicare UPIN
KS010581Medicare ID - Type UnspecifiedMEDICARE