Marie Bernice Sander, RN, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2012040371 Issued in MO

Practice address

851 E 5TH St
Suite 208
Washington, MO 63090-3135

Phone

(636) 390-9090

Fax

(636) 390-9091

NPI assigned

Feb 26, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Marie Bernice Sander-Bolego Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1467792523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST",
            "address_2": "SUITE 208",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903135",
            "telephone_number": "636-390-9090",
            "fax_number": "636-390-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST",
            "address_2": "SUITE 208",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903135",
            "telephone_number": "636-390-9090",
            "fax_number": "636-390-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDER",
        "first_name": "MARIE",
        "middle_name": "BERNICE",
        "credential": "RN, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2012040371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "SANDER-BOLEGO",
            "middle_name": "BERNICE",
            "credential": "RN, ANP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gina Elizabeth Ruether, M.S.,CCC-SLP
• Brad Evan Rumancik, MD
• Kirstin Jenna Russell, PMHNP
• Sarah Ann Russell, AGACNP-BC
• Tina Ryan, FNP
• Sanjay Ghosh PHD MD PC
• Sanjay Ghosh PHD MD PC
• Cheryl Collier Savage, LCSW
• Garry R Scarato, MD
• Thomas Schallom

• Adult Health Nurse Practitioner in Washington, MO
• Providers in Washington, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.