Sanderson, Dale Michael

Sanderson, Dale Michael is an individual health care provider with primary practice located at 8300 Constantin Blvd , Baton Rouge LA 70809-3489. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as his primary health care specialty. Sanderson, Dale Michael can be contacted via phone (225) 374-4325.

Contact Information

Primary practice address
8300 Constantin Blvd Baton Rouge LA 70809-3489
Phone: (225) 374-4325
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X TAP002754 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X AP06807 Louisiana

Profile Details

NPI number 1659643054
LBN Legal business name Sanderson, Dale Michael
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2012
Last updated Oct 8th, 2020 - about 5 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 1659643054 NPPES
Louisiana Other PENDING BCBS LA
Louisiana MEDICAID 2190598 BCBS LA

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