Individual
MARY SANDRA SANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
38 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-0426
Mailing address
550 SW 3RD ST APT 5, NEWPORT, OR 97365-4902
(541) 265-0426
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
082009845RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49120361
—
CO
Enumeration date
04/03/2007
Last updated
03/07/2014
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