Provider Demographics
NPI:1215240973
Name:BROWN, SAUNDRA MARIE (LPN)
Entity type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SAUNDRA
Other - Middle Name:MARIE
Other - Last Name:BUFANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA,LPN
Mailing Address - Street 1:BUILDING 4076 NEELEY RD
Mailing Address - Street 2:
Mailing Address - City:FT WAINRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703-3165
Mailing Address - Country:US
Mailing Address - Phone:907-361-6370
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 4076 NEELEY RD
Practice Address - Street 2:
Practice Address - City:FT WAINRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-3165
Practice Address - Country:US
Practice Address - Phone:907-361-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNUR P 6686164W00000X
NV13391164W00000X
AL2-051902164W00000X
FLPN 5150633164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse