Dubose, Sandra Elaine

Dubose, Sandra Elaine is an individual health care provider with primary practice located at 1631 Gordon Hwy Ste 17A , Augusta GA 30906-2229. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dubose, Sandra Elaine can be contacted via phone (706) 230-7006.

Contact Information

Primary practice address
1631 Gordon Hwy Ste 17A Augusta GA 30906-2229
Phone: (706) 230-7006
Fax: (762) 257-7442
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 129 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN103532 Georgia

Profile Details

NPI number 1548264047
LBN Legal business name Dubose, Sandra Elaine
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Mar 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548264047 NPPES
South Carolina MEDICAID NP0278
South Carolina MEDICAID 000829595A

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