Provider Demographics
NPI:1437043940
Name:BAUER, SANDDRICK JC (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SANDDRICK
Middle Name:JC
Last Name:BAUER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 SURREY LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-7136
Mailing Address - Country:US
Mailing Address - Phone:972-974-4017
Mailing Address - Fax:
Practice Address - Street 1:1712 SURREY LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-7136
Practice Address - Country:US
Practice Address - Phone:972-974-4017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1195296363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily