Provider Demographics
NPI:1407866510
Name:ST MARTIN, SAUNDA (NP, APRN)
Entity Type:Individual
Prefix:
First Name:SAUNDA
Middle Name:
Last Name:ST MARTIN
Suffix:
Gender:F
Credentials:NP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56619-0155
Mailing Address - Country:US
Mailing Address - Phone:218-209-1137
Mailing Address - Fax:
Practice Address - Street 1:24760 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:REDLAKE
Practice Address - State:MN
Practice Address - Zip Code:56671
Practice Address - Country:US
Practice Address - Phone:218-679-3912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1077485364S00000X
MNR107748-5364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN014080500Medicaid
MN107121OtherHEALTH PARTNERS
ND13481Medicaid
MN78M12STOtherBCBS
MNP00184098OtherRR MEDICARE
MN0199999OtherMEDICA