Provider Demographics
NPI:1841474715
Name:MACSWEENEY, SANDRA M (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:MACSWEENEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:MACSWEENEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:778-563-7748
Mailing Address - Fax:
Practice Address - Street 1:13815 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-2069
Practice Address - Country:US
Practice Address - Phone:941-426-4900
Practice Address - Fax:941-423-9422
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11031252363LF0000X
FL11031252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily