Provider Demographics
NPI:1316771017
Name:SANDERS, KARA DANIELLE (NP)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:DANIELLE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:DANIELLE
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20133A COUNTY ROAD 87
Mailing Address - Street 2:
Mailing Address - City:ROBERTSDALE
Mailing Address - State:AL
Mailing Address - Zip Code:36567-2799
Mailing Address - Country:US
Mailing Address - Phone:251-233-9592
Mailing Address - Fax:
Practice Address - Street 1:106 W MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1935
Practice Address - Country:US
Practice Address - Phone:251-943-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-172687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily