Provider Demographics
NPI:1366702987
Name:ARMSTRONG, SANDRA SUE (APN)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SUE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2949
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-2949
Mailing Address - Country:US
Mailing Address - Phone:907-262-3119
Mailing Address - Fax:907-262-9290
Practice Address - Street 1:136 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-9072
Practice Address - Country:US
Practice Address - Phone:479-437-3449
Practice Address - Fax:479-243-0285
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK135146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR192859758Medicaid
AR192859758Medicaid