Provider Demographics
NPI:1750752648
Name:BANDY MCKEE, SARAH BETH (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:BANDY MCKEE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 WHITE BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5794
Mailing Address - Country:US
Mailing Address - Phone:208-420-3854
Mailing Address - Fax:
Practice Address - Street 1:1522 W FRANK AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3334
Practice Address - Country:US
Practice Address - Phone:936-639-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-17
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1634A363LP0808X
TXAP129393363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX459878YLP3Medicaid