Provider Demographics
NPI:1740661420
Name:SANDER, MAUREEN (ARNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:SANDER
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 1:2100 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4379
Mailing Address - Country:US
Mailing Address - Phone:502-160-1008
Mailing Address - Fax:850-431-6315
Practice Address - Street 1:2100 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4379
Practice Address - Country:US
Practice Address - Phone:850-216-0100
Practice Address - Fax:850-431-6315
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3238272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily