Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 5013141 | NC |
NPI | 1023646569 |
---|---|
Provider Name | Mrs. Donna C Sandifer |
First Address | Hickory, NC 28602-9617 |
Second Address | Hickory, NC 28602-9617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2020 |
Last Update Date | 08/11/2020 |