Healthcare Provider Details

I. General information

NPI: 1407866510
Provider Name (Legal Business Name): SAUNDA ST MARTIN NP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24760 HOSPITAL DRIVE
REDLAKE MN
56671
US

IV. Provider business mailing address

PO BOX 155
BEMIDJI MN
56619-0155
US

V. Phone/Fax

Practice location:
  • Phone: 218-679-3912
  • Fax:
Mailing address:
  • Phone: 218-209-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberR1077485
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberR107748-5
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: