Provider Demographics
NPI:1386411148
Name:CARBAJAL, SANDY (FNP-C)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:CARBAJAL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:CARBAJAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SANDY CARBAJAL FNP-C
Mailing Address - Street 1:556 BLUEBIRD LN
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-4251
Mailing Address - Country:US
Mailing Address - Phone:972-617-6660
Mailing Address - Fax:
Practice Address - Street 1:556 BLUEBIRD LN
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-4251
Practice Address - Country:US
Practice Address - Phone:972-617-6660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF10230414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily