MEDICARE: SAUNDA ST MARTIN NP, APRN

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	364S00000X	Clinical Nurse Specialist	R1077485	MN
2	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	R107748-5	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00184098	OTHER	MN	RR MEDICARE

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	107121	OTHER	MN	HEALTH PARTNERS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	78M12ST	OTHER	MN	BCBS
6	0199999	OTHER	MN	MEDICA

General Provider Information

NPI Number	:	1407866510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAUNDA ST MARTIN NP, APRN

Provider Business Mailing Address
First Line	:	PO BOX 155
Second Line	:
City	:	BEMIDJI
State	:	MN
Zip	:	56619-0155
Country	:	US
Telephone Number	:	218-209-1137
Fax Number	:

Provider Business Practice Location Address
First Line	:	24760 HOSPITAL DRIVE
Second Line	:
City	:	REDLAKE
State	:	MN
Zip	:	56671
Country	:	US
Telephone Number	:	218-679-3912
Fax Number	:

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	08/17/2018

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