Provider Demographics
NPI:1710347091
Name:PESTANA, ANA MARIA (RN)
Entity Type:Individual
Prefix:
First Name:ANA MARIA
Middle Name:
Last Name:PESTANA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANA MARIA
Other - Middle Name:
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:39 ANTHONY DR
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-6221
Mailing Address - Country:US
Mailing Address - Phone:508-815-7501
Mailing Address - Fax:
Practice Address - Street 1:39 ANTHONY DR
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-6221
Practice Address - Country:US
Practice Address - Phone:508-815-7501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN254621163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse