Provider Demographics
NPI:1396775755
Name:SANDERS, LINDA GAYLE (NURSE ANESTHETIST)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:GAYLE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:NURSE ANESTHETIST
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:GAYLE
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE ANESTHETIST
Mailing Address - Street 1:755 N. 11TH STREET, SUITE P3600
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77726-5587
Mailing Address - Country:US
Mailing Address - Phone:409-838-5214
Mailing Address - Fax:
Practice Address - Street 1:755 N. 11TH STREET, SUITE P3600
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77726-5587
Practice Address - Country:US
Practice Address - Phone:409-838-5214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253707367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered