Provider Demographics
NPI:1932060373
Name:WHEATON, SANDRA MICHELLE (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MICHELLE
Last Name:WHEATON
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 N QUINCY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-3810
Mailing Address - Country:US
Mailing Address - Phone:641-683-4300
Mailing Address - Fax:641-683-4302
Practice Address - Street 1:1020 N QUINCY AVE STE 1
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-3810
Practice Address - Country:US
Practice Address - Phone:641-683-4300
Practice Address - Fax:641-683-4302
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA119537163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management