| Ms Sandra Dodge, APRN,BC | |
| 
					Highway 191 And Ph Drive, Chinle, AZ 86503  | |
| (928) 674-7420 | |
| (928) 674-7461 | 
| Full Name | Ms Sandra Dodge | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner | 
| Location | Highway 191 And Ph Drive, Chinle, Arizona | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1558399113 | NPI | - | NPPES | 
| 3102957 | Medicaid | NM | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363L00000X | Nurse Practitioner | R18238 (New Mexico) | Primary | 
| Entity Name | Dhhs Phs Naihs Shiprock Hospital | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1780639971 PECOS PAC ID: 0749193837 Enrollment ID: O20031105000809  | 
| Entity Name | Dhhs Phs Naihs Chinle Comprehensive Health Care Facility | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1508800129 PECOS PAC ID: 9436062585 Enrollment ID: O20031106000210  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ms Sandra Dodge, APRN,BC Po Box Ph, Cchcf, Chinle, AZ 86503 Ph: (928) 674-7420  | Ms Sandra Dodge, APRN,BC Highway 191 And Ph Drive, Chinle, AZ 86503 Ph: (928) 674-7420  | 
Jacqueline Selig, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Highway 191 And Hospital Road, Chinle, AZ 86503 Phone: 928-674-7166 Fax: 928-674-7705  | |
Gail Ratko, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Highway 191 And Hospital Road, Chinle, AZ 86503 Phone: 928-674-7166 Fax: 928-674-7705  | |
Samantha Austin,  Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: U.s. 191 & Hospital Drive, Chinle, AZ 86503 Phone: 928-674-7001  | |
Ms. Annie R. Moon, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Off Hwy 191 Hospital Road, Chinle, AZ 86503 Phone: 928-674-7001 Fax: 928-674-7705  | |
Mrs. Marie Atamene Charles, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Highway 191 & Hospital Drive, Chinle, AZ 86503 Phone: 928-674-7655  | |
Henrietta J Yazzie,  Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Highway 191, Chinle, AZ 86503 Phone: 928-674-7001  |