Martin, Sandra L

Martin, Sandra L is an sole proprietor health care provider with primary practice located at 100 Navarre Pl Suite 6600, South Bend IN 46601-1156. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Martin, Sandra L can be contacted via phone (574) 232-7227.

Contact Information

Primary practice address
100 Navarre Pl Suite 6600 South Bend IN 46601-1156
Phone: (574) 232-7227
Fax: (574) 232-2064
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001851A Indiana

Profile Details

NPI number 1851373898
LBN Legal business name Martin, Sandra L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 16th, 2005
Last updated Mar 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851373898 NPPES
Indiana Other 000000742868 BCBS
Indiana MEDICAID 200303930 BCBS
Indiana Other 352145705 BCBS

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