Individual
SANDRA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-5599
(336) 716-3202
Mailing address
PO BOX 751730, CHARLOTTE, NC 28275-1730
(336) 716-5599
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
055258
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
2083
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052054
—
NC
05
—
NAN518
—
SC
Enumeration date
05/10/2006
Last updated
12/08/2025
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