Provider Demographics
NPI:1932939600
Name:SANDEL, STACY
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:SANDEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8411 TAMPICO PL
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-1135
Mailing Address - Country:US
Mailing Address - Phone:505-301-6568
Mailing Address - Fax:
Practice Address - Street 1:8411 TAMPICO PL
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-1135
Practice Address - Country:US
Practice Address - Phone:505-301-6568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula