Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 71002270A | IN |
NPI | 1003995820 |
---|---|
Provider Name | Rosie K Sandhu |
First Address | Indianapolis, IN 46237-2601 |
Second Address | Indianapolis, IN 46237-2601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 27/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200862770 | (05) | IN |