Provider Demographics
NPI:1780050864
Name:TAUBITZ, SANDRA T
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:T
Last Name:TAUBITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:T
Other - Last Name:TAUBITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:34416 ZACHARY CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-6124
Mailing Address - Country:US
Mailing Address - Phone:586-716-3909
Mailing Address - Fax:
Practice Address - Street 1:34416 ZACHARY CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-6124
Practice Address - Country:US
Practice Address - Phone:586-716-3909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704091832163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health