Gates-Manna, Sandra R

Gates-Manna, Sandra R is an individual health care provider with primary practice located at 1509 State St , La Porte IN 46350-3115. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gates-Manna, Sandra R can be contacted via phone (219) 325-5434.

Contact Information

Primary practice address
1509 State St La Porte IN 46350-3115
Phone: (219) 325-5434
Fax: (219) 325-7655
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 28125285A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71003896A Indiana

Profile Details

NPI number 1124396072
LBN Legal business name Gates-Manna, Sandra R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2011
Last updated Nov 27th, 2012 - about 14 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 1124396072 NPPES
Indiana MEDICAID 201059520
Indiana Other 000000758275
Indiana Other 151020006

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