Provider Demographics
NPI:1437875044
Name:SAN MARTIN, RANA G (RN)
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:G
Last Name:SAN MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5524 CHESTERMILL DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7248
Mailing Address - Country:US
Mailing Address - Phone:703-731-6096
Mailing Address - Fax:
Practice Address - Street 1:5524 CHESTERMILL DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7248
Practice Address - Country:US
Practice Address - Phone:703-731-6096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001124495163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse