Provider Demographics
NPI:1447730585
Name:LINGENFELTER, SANDRA (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LINGENFELTER
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4642 COLONY DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-6482
Mailing Address - Country:US
Mailing Address - Phone:409-781-6399
Mailing Address - Fax:
Practice Address - Street 1:3080 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4606
Practice Address - Country:US
Practice Address - Phone:409-212-6121
Practice Address - Fax:409-212-6779
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138500363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care