Provider Demographics
NPI:1679352371
Name:DUKE, SANDY SAMIR-HADDAD (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:SAMIR-HADDAD
Last Name:DUKE
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:MISS
Other - First Name:SANDY
Other - Middle Name:SAMIR
Other - Last Name:HADDAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:3065 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1638
Mailing Address - Country:US
Mailing Address - Phone:989-493-4534
Mailing Address - Fax:
Practice Address - Street 1:5415 CARDINAL SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-8200
Practice Address - Country:US
Practice Address - Phone:989-790-4855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704341490363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner