MEDICARE: SANDRA PENA CRNA

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
1	367500000X	Certified Registered Nurse Anesthetist	055258	NC
2	367500000X	Certified Registered Nurse Anesthetist	2083	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1336198787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA PENA CRNA

Provider Business Mailing Address
First Line	:	PO BOX 751730
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1730
Country	:	US
Telephone Number	:	336-716-5599
Fax Number	:	336-716-3202

Provider Business Practice Location Address
First Line	:	MEDICAL CENTER BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	336-716-5599
Fax Number	:	336-716-3202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	12/08/2025

Similar Medicare Providers

1528376738 — MRS. HEATHER RENAE SMITH CRNA
Practice Location Address:

MEDICAL CENTER BLVD
WINSTON SALEM, NC
27157-0001

Practice Phone: 336-716-3069
Practice Fax:

1669855813 — MISS BRITTANY ANN DOMINGUEZ
Practice Location Address:

MEDICAL CENTER BLVD
WINSTON SALEM, NC
27157-0001

Practice Phone: 336-716-2255
Practice Fax: 336-716-3202

1356737969 — SCOTT SYLVESTER
Practice Location Address:

MEDICAL CENTER BOULEVARD , JANEWAY TOWER 5TH FLOOR- PLASTIC SURGERY
WINSTON SALEM, NC
27157-0001

Practice Phone: 336-716-4171
Practice Fax: 336-716-9386

1649859810 — MEYHA NATASHA SWAROOP MD
Practice Location Address:

MEDICAL CENTER BLVD
WINSTON SALEM, NC
27157-0001

Practice Phone: 336-716-4615
Practice Fax: 336-716-6937

1902168024 — DR. WILEY DARRO THUET M.D.
Practice Location Address:

WAKE FOREST BAPTIST HOSPITAL , MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC
27157-0001

Practice Phone: 336-716-2011
Practice Fax:

1063117208 — PAUL EBUBECHUKWU OKOYEH MD
Practice Location Address:

MEDICAL CENTER BLVD
WINSTON SALEM, NC
27157-0001

Practice Phone: 336-716-4551
Practice Fax:

Directions to “ SANDRA PENA CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.