Provider Demographics
NPI:1548971062
Name:SASSER, WANDA L
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:L
Last Name:SASSER
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 1:7283 HWY 42 WEST STE 102
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-7530
Mailing Address - Country:US
Mailing Address - Phone:919-795-0411
Mailing Address - Fax:
Practice Address - Street 1:1631 MIDTOWN PL STE 104-171
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-1300
Practice Address - Country:US
Practice Address - Phone:919-795-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)