Provider Demographics
NPI:1164220638
Name:MORELOCK, SANDRA M
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:MORELOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2662 B AVE
Mailing Address - Street 2:
Mailing Address - City:COIN
Mailing Address - State:IA
Mailing Address - Zip Code:51636-4037
Mailing Address - Country:US
Mailing Address - Phone:712-310-0690
Mailing Address - Fax:
Practice Address - Street 1:807 TARA RD
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2117
Practice Address - Country:US
Practice Address - Phone:402-331-0439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant