Provider Demographics
NPI:1356631204
Name:PREVIL, SANITA T (CD(DONA))
Entity type:Individual
Prefix:
First Name:SANITA
Middle Name:T
Last Name:PREVIL
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9419 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1802
Mailing Address - Country:US
Mailing Address - Phone:301-996-5964
Mailing Address - Fax:
Practice Address - Street 1:9419 LEE HWY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1802
Practice Address - Country:US
Practice Address - Phone:301-996-5964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9399OtherDONA