SANDRA LYNNE MALLISHAM FPMHNP-BC NPI 1053683102

NPI Information

NPI: 1053683102
Provider Name: SANDRA LYNNE MALLISHAM, FPMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
2040 BABCOCK RD
SUITE 403
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 858-9980
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Sandra Lynne Mallisham, FPMHNP-BC is a psychiatric/mental health nurse practitioner in San Antonio, TX. Sandra Lynne Mallisham, FPMHNP-BC NPI is 1053683102. 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:

2040 BABCOCK RD
SUITE 403
SAN ANTONIO, TX
ZIP 78229-425
Phone: (210) 858-9980
Fax: (210) 858-9990

The enumeration date for this NPI number is 2/6/2012 and was last updated on 2/6/2012.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	700915	TEXAS	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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