Sandoval, Sarah Lynette

Sandoval, Sarah Lynette is an sole proprietor health care provider with primary practice located at 509 Hamacher St Ste 103 , Waterloo IL 62298-1592. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Allopathic & Osteopathic Physicians / Adult Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Sandoval, Sarah Lynette can be contacted via phone (618) 939-2273.

Contact Information

Primary practice address
509 Hamacher St Ste 103 Waterloo IL 62298-1592
Phone: (618) 939-2273
Fax: (618) 939-0245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 041427444 Illinois
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 2012020830 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209016207 Illinois

Profile Details

NPI number 1093224438
LBN Legal business name Sandoval, Sarah Lynette
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2017
Last updated Sep 3rd, 2019 - 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 1093224438 NPPES
Missouri MEDICAID 1649315219

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