Sandeen, Mary E

Sandeen, Mary E is an individual health care provider with primary practice located at 1003 Willow Creek Rd , Prescott AZ 86301-1641. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Sandeen, Mary E can be contacted via phone (928) 771-5662.

Contact Information

Primary practice address
1003 Willow Creek Rd Prescott AZ 86301-1641
Phone: (928) 771-5662
Fax: (928) 771-5249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN104425 Arizona

Profile Details

NPI number 1639193881
LBN Legal business name Sandeen, Mary E
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Feb 3rd, 2012 - about 12 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 1639193881 NPPES
Arizona MEDICAID 468373

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