Provider Demographics
NPI:1023169679
Name:HESS, SANDY JO (RN)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:JO
Last Name:HESS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC BOX 536
Mailing Address - Street 2:
Mailing Address - City:COUNCIL
Mailing Address - State:VA
Mailing Address - Zip Code:24260
Mailing Address - Country:US
Mailing Address - Phone:276-964-0555
Mailing Address - Fax:276-964-2999
Practice Address - Street 1:305 OLD KENTUCKY TURNPIKE
Practice Address - Street 2:
Practice Address - City:CEDAR BLUFF
Practice Address - State:VA
Practice Address - Zip Code:24609
Practice Address - Country:US
Practice Address - Phone:276-964-0555
Practice Address - Fax:276-964-2999
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001170061163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy