Nicole Sanderson (NPI# 1013465152, PAC ID# 6709165855) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1013465152 |
| PAC ID by PECOS | 6709165855 |
| Professional Enrollment ID | I20161114001908 |
| Full Name | Nicole Sanderson |
| Organization Legal Name | LUTHERAN MEDICAL GROUP LLC |
| Address |
3534 Brooklyn Ave Fort Wayne IN 46809-1361 |
| Phone Number | 2604322297 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4981751617 |
| Number of Group Practice Members | 211 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150045 | DEKALB HEALTH |
| 150150 | DUPONT HOSPITAL LLC |
| Address | Phone | Organization |
|---|---|---|
| 2516 E Dupont Rd, Fort Wayne, IN 46825-1608 | 2604346076 | LUTHERAN MEDICAL GROUP LLC |
| 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2604322297 | LUTHERAN MEDICAL GROUP LLC |
| Organization Legal Name | LUTHERAN MEDICAL GROUP LLC |
| Physicians | 216 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Stemen | Nurse Practitioner | Lutheran Medical Group LLC | 11115 Lima Rd, Fort Wayne, IN 46818-9536 |
| David C. Cronin | General Surgery | Lutheran Medical Group LLC | 2516 E Dupont Rd, Fort Wayne, IN 46825-1608 |
| George Steven Kalesperis | Family Medicine | Lutheran Medical Group LLC | 6511 E State Blvd, Fort Wayne, IN 46815-7026 |
| Ann R. Moore | Nurse Practitioner | Lutheran Medical Group LLC | 303 S Main St, Bluffton Regional Hospital, Bluffton, IN 46714-2503 |
| Stephanie A Clouse | Nurse Practitioner | Lutheran Medical Group LLC | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 |
| Kanika Jaggi | Family Medicine | Lutheran Medical Group LLC | 5717 S Anthony Blvd, Suite 800, Fort Wayne, IN 46806-3393 |
| Ibad Ul-haq Farooqui | Family Medicine | Lutheran Medical Group LLC | 402 E Main St, Fort Wayne, IN 46802-1910 |
| Christine Springer | Nurse Practitioner | Lutheran Medical Group LLC | 10429 Hosler Rd, Leo, IN 46765-9739 |
| Leia A Becktell | Nurse Practitioner | Lutheran Medical Group LLC | 7952 W Jefferson Blvd, The Orthopedic Hospital, Fort Wayne, IN 46804-4140 |
| Christi Ann Wallace | Family Medicine | Lutheran Medical Group LLC | 1302 Minnich Rd, New Haven, IN 46774-2052 |
| Street Address |
3534 BROOKLYN AVE |
| City | FORT WAYNE |
| State | IN |
| Zip | 46809-1361 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brian A Adams | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Erin Lynn Shaw | Nurse Practitioner | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Nirupama E Jerome | Nurse Practitioner | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Kent Farnsworth | Internal Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Edna M Manalo | Physician Assistant | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Maria Theresa A Cabe | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Gregory C Dowling | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Justina M Girod | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Kristina R Leavell | Physician Assistant | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Anthony C Henry | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey Levenda | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Jessica L Ottenweller Butcher | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Herbert Kj Acker | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Peter Anthony Jakacki | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Susan M Maloney | Nurse Practitioner | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Scott Thomas Armstrong | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Kimberly Million | Nurse Practitioner | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Dana Rae Forrest | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Shawn Lazoff | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Christopher A Baltes | Family Medicine | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Find all physicians in zip 46809 | |||
| City | FORT WAYNE |
| Zip Code | 46809 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | FORT WAYNE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Nicole Sanderson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.