Provider Demographics
NPI:1316339831
Name:MAINS, SANDRA LEE (RN)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LEE
Last Name:MAINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1462
Mailing Address - Country:US
Mailing Address - Phone:302-645-3275
Mailing Address - Fax:
Practice Address - Street 1:424 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1462
Practice Address - Country:US
Practice Address - Phone:412-229-8244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELI-0041856163W00000X
PARN571586163W00000X
NJ26NR15728300163W00000X
GARN221490163W00000X
TX810388163W00000X
VT26.0081756163W00000X
OHRN380199163W00000X
IN28210643A163W00000X
CA95022874163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse