Provider Demographics
NPI:1316235351
Name:TABOR, SANDRA K (ARNP-C)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:TABOR
Suffix:
Gender:F
Credentials:ARNP-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1133 COLLEGE AVE # B100
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2770
Mailing Address - Country:US
Mailing Address - Phone:785-565-9500
Mailing Address - Fax:785-565-9595
Practice Address - Street 1:1133 COLLEGE AVE # B100
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-565-9500
Practice Address - Fax:785-565-9595
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS5375396363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner