Provider Demographics
NPI:1104155571
Name:BIELANSKI, SANDRA (CNP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:BIELANSKI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8227 KENSINGTON SQ
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4401
Mailing Address - Country:US
Mailing Address - Phone:440-376-6570
Mailing Address - Fax:
Practice Address - Street 1:8227 KENSINGTON SQ
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4401
Practice Address - Country:US
Practice Address - Phone:440-376-6570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10889363LA2200X
FLAPRN11026320363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3091907Medicaid