Sandra Mae Stuit, NP-C

Individual provider Active NPI Family Nurse Practitioner · Breentwood, TN

NPI 1861707374 · NPPES record last updated Aug 10, 2010

Key facts

NPI
1861707374
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
4704160473 (MI)
Practice address
10 Cadillac Drive Ste 350
Two Creekside Crossing
Breentwood, TN 37027
Phone
(888) 584-0077
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704160473MIMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704160473 MI Yes

Addresses

Primary practice location

10 Cadillac Drive Ste 350
Two Creekside Crossing
Breentwood, TN 37027

Mailing address

2731 Durham Ave NE
Grand Rapids, MI 49505-3853
Phone (616) 363-7805

Sources for this page

Verify at the official NPI Registry.