Provider Demographics
NPI:1851321970
Name:CADWELL, SANDRA D (ANP, BC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:D
Last Name:CADWELL
Suffix:
Gender:F
Credentials:ANP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 INDIAN RIVER RD STE C7
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3691
Mailing Address - Country:US
Mailing Address - Phone:203-497-3861
Mailing Address - Fax:203-718-2381
Practice Address - Street 1:240 INDIAN RIVER RD STE C7
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3691
Practice Address - Country:US
Practice Address - Phone:203-497-3861
Practice Address - Fax:203-718-2381
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81098363LA2200X
MER027630363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEP37101Medicare UPIN