Basic Information
| Provider Information | |||||||||
| NPI: | 1063792406 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANDERS | ||||||||
| FirstName: | LADONNA | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 650 JOEL DRIVE | ||||||||
| Address2: | BLANCHFIELD ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FORT CAMPBELL | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422235349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707988151 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 650 JOEL DRIVE | ||||||||
| Address2: | BLANCHFIELD ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FORT CAMPBELL | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422235349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707988151 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2011 | ||||||||
| LastUpdateDate: | 08/17/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 112039 | TN | Y | Nursing Service Providers | Registered Nurse |
No ID Information.