MEMPHIS CHARDELL SANDOVAL (NPI# 1720692494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720692494 |
| Entity Type | Individual |
| Full Name | MEMPHIS CHARDELL SANDOVAL |
| Credential | NP |
| Practice Address |
131 S. Seaway Dr. Muskegon MI 49441 |
| Mailing Address |
925 Bowline Rd Apt D Norton Shores MI 49441-6172 |
| Practice Telephone | 2313758065 |
| Mailing Telephone | 2317364075 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704299093 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
131 S. SEAWAY DR. |
| City | MUSKEGON |
| State | MI |
| Zip Code | 49441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598222952 | Kimberlee K Erickson-worpel Ma,llp | Psychologist | 3611 Henry Street, Norton Shores, MI 49441 | 2019-02-21 |
| 1164921011 | Brittany Ann Bayne | Behavior Technician | 640 Seminole, Muskegon, MI 49441 | 2018-02-06 |
| 1497273403 | Rx Optical Laboratories, Inc. | Optometrist | 3445 Henry St, Norton Shores, MI 49441 | 2017-08-30 |
| 1801320072 | Gentle Souls Home Care, LLC | In Home Supportive Care | 2743 Henry Street Pmb #117, Muskegon, MI 49441 | 2017-04-14 |
| 1467814889 | Lyle Karp | Hearing Instrument Specialist | 3145 Henry St., Muskegon, MI 49441 | 2016-03-24 |
| 1649653817 | Jessica Marie Lambert | Dentist | 5978 Harvey St., Muskegon, MI 49441 | 2015-07-06 |
| 1114320595 | Mark Reider | Counselor | 3944 Grand Haven Rd Apt 204c, Norton Shores, MI 49441 | 2014-09-30 |
| 1679826002 | Kathleen M Dole | Social Worker | 800 E Ellis Rd Ste 222, Norton Shores, MI 49441 | 2012-10-23 |
| 1144523119 | Terri Lee Garza | Social Worker | 1095 Third St, Muskegon, MI 49441 | 2010-12-14 |
| 1821250218 | Rick Stanton Enterprises Incorporated Dba Lauren Taylor Eyewear | Clinic/Center | 1945 Lakeshore Dr, Muskegon, MI 49441 | 2008-06-27 |
| Find all providers in zip 49441 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952898686 | Michelle Reed | Nurse Practitioner | 125 E Southern Ave, Muskegon, MI 49442-5041 | 2018-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588282784 | Mary Tackbary | Nurse Practitioner | 3932 W Briar Hill Dr, Maple City, MI 49664-9521 | 2020-07-14 |
| 1962032227 | Westlake Consultation Center | Nurse Practitioner | 4870 W Clark Rd Ste 100, Ypsilanti, MI 48197-1104 | 2020-01-24 |
| 1689211823 | Wanda Edwards | Nurse Practitioner | 29000 Inkster Rd Ste 115, Southfield, MI 48034-1097 | 2019-12-06 |
| 1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
| 1457905614 | Natalie Poole | Nurse Practitioner | 23077 Greenfield Rd Ste 260, Southfield, MI 48075-3745 | 2019-07-26 |
| 1629535117 | Valerie Baunoch | Nurse Practitioner | 2057 E West Maple Rd, Commerce Twp, MI 48390 | 2019-02-21 |
| 1790293488 | Infinity Hope Center LLC | Nurse Practitioner | 260 Vinewood St Ste 100a8919, Detroit, MI 48216-1667 | 2018-01-16 |
| 1033659644 | Anne Zamler | Nurse Practitioner | 14230 W Mcnichols Rd, Detroit, MI 48235-3912 | 2017-03-01 |
| 1396289120 | Next Level Up Health & Wellness Inc. | Nurse Practitioner | 28423 Parkwood St, Inkster, MI 48141-1669 | 2016-12-13 |
| 1801343942 | Gwendolyn K La Croix | Nurse Practitioner | 7521 N Telegraph Rd Ste 1, Newport, MI 48166-9398 | 2016-09-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.