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General NPI Number Information
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NPI Number | 1679378822
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Entity Type | Individual
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Provider Name | SANDRA MARNITA MCCANN BSN, RN, CCM
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 77 NEALY AVE MEDICAL CASE MANAGEMENT -SGHM
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City | HAMPTON
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State | VA
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Zip | 23665-2080
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Country | US
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Telephone | 757-225-6732
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Fax | 757-764-0968
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Provider Business Mailing Address
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Address Line | 703 MILFORD AVE
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City | HAMPTON
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State | VA
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Zip | 23661-1141
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Country | US
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Telephone | 757-880-4294
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Fax | 757-764-0968
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 604739
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License Number State | VA
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