MS. SANDRA S NIENABER NPI 1104015742

NPI Information

  • NPI: 1104015742
  • Provider Name: MS. SANDRA S NIENABER
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 420 E STATE ST
    WINNEBAGO COUNTY JAIL
    ROCKFORD, IL
    ZIP 61104
  • Phone: (815) 319-6634

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NPI Details

MS. Sandra S Nienaber is a family nurse practitioner in Rockford, IL. MS. Sandra S Nienaber NPI is 1104015742. 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:

420 E STATE ST
WINNEBAGO COUNTY JAIL
ROCKFORD, IL
ZIP 61104-015
Phone: (815) 319-6634
Fax: (815) 395-5644

The enumeration date for this NPI number is 10/19/2007 and was last updated on 10/19/2007.

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
1363LF0000XNurse PractitionerFamily209005207ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1K21095MEDICARE PINILLINOIS

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: 11/21/2025

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