Provider Demographics
NPI:1215168901
Name:LUMLEY, SANDRA L (RN, BSN, CNOR)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:LUMLEY
Suffix:
Gender:F
Credentials:RN, BSN, CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15711 LEAVENWORTH RD
Mailing Address - Street 2:
Mailing Address - City:BASEHOR
Mailing Address - State:KS
Mailing Address - Zip Code:66007-9769
Mailing Address - Country:US
Mailing Address - Phone:913-620-2764
Mailing Address - Fax:
Practice Address - Street 1:15711 LEAVENWORTH RD
Practice Address - Street 2:
Practice Address - City:BASEHOR
Practice Address - State:KS
Practice Address - Zip Code:66007-9769
Practice Address - Country:US
Practice Address - Phone:913-620-2764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1373156041163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant