Provider Demographics
NPI:1396069860
Name:KINDNESS, SANDRA J (C-FNP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:KINDNESS
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 RAY NORRISH DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-1520
Mailing Address - Country:US
Mailing Address - Phone:513-791-5548
Mailing Address - Fax:513-791-5549
Practice Address - Street 1:440 RAY NORRISH DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-1520
Practice Address - Country:US
Practice Address - Phone:513-791-5548
Practice Address - Fax:513-791-5549
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11240-NP363LF0000X
MARN2296236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218152101Medicaid
TX218152101Medicaid