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NPI Code Detail

MEDICARE: SANA REMILLARD NO

MEDICARE: SANA REMILLARD NO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerNP 10283CA
2363LX0001XObstetrics & Gynecology Nurse PractitionerNP 10283CA
3363L00000XNurse PractitionerNP 10283CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN 509722OTHERCAREGISTERED NURSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225086556
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANA REMILLARD NO
Provider Business Mailing Address
First Line : 742 W HIGHLAND AVE
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92405-3839
Country : US
Telephone Number : 909-881-7320
Fax Number : 909-881-7330
Provider Business Practice Location Address
First Line : 742 W HIGHLAND AVE
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92405-3839
Country : US
Telephone Number : 909-881-7320
Fax Number : 909-881-7330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 04/28/2016

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Directions to “ SANA REMILLARD NO” Practice Location

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