Provider Demographics
NPI:1922845742
Name:SANDERS, CRAIG STEFAN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:STEFAN
Last Name:SANDERS
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 NORTH OXFORD VALLEY RD
Mailing Address - Street 2:STE 400
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:609-784-4265
Mailing Address - Fax:
Practice Address - Street 1:360 N OXFORD VALLEY RD
Practice Address - Street 2:STE 400
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8302
Practice Address - Country:US
Practice Address - Phone:215-943-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029569363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner