Provider Demographics
NPI:1861145369
Name:TISSANDIER, SANDRA KAY (CNP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KAY
Last Name:TISSANDIER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:KAY
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4750 E. GAIBRAITH ROAD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236
Mailing Address - Country:US
Mailing Address - Phone:513-686-5392
Mailing Address - Fax:513-686-5394
Practice Address - Street 1:4750 E. GAIBRAITH ROAD
Practice Address - Street 2:SUITE 7
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236
Practice Address - Country:US
Practice Address - Phone:513-686-5392
Practice Address - Fax:513-686-5394
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.343220163W00000X
OHAPRN.CNP.0030988363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse