MEMPHIS CHARDELL SANDOVAL NP NPI 1720692494

NPI Information

NPI: 1720692494
Provider Name: MEMPHIS CHARDELL SANDOVAL, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
240 N TILLOTSON AVE
MUNCIE, IN
ZIP 47304
Phone: (765) 288-1928
Get Directions

Memphis Chardell Sandoval, NP is a psychiatric/mental health nurse practitioner in Muncie, IN. Memphis Chardell Sandoval, NP NPI is 1720692494. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

240 N TILLOTSON AVE
MUNCIE, IN
ZIP 47304-988
Phone: (765) 288-1928

The NPI 1720692494 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/1/2020 and was last updated on 3/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		4704299093	MICHIGAN	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	4704299093	MICHIGAN	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	863235	NEVADA	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	71014109A	INDIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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