Provider Demographics
NPI:1144030453
Name:SANTANA, SHEENA MARIE
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:MARIE
Last Name:SANTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 RUBENS CIR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-8393
Mailing Address - Country:US
Mailing Address - Phone:803-960-6160
Mailing Address - Fax:
Practice Address - Street 1:301 S KING ST
Practice Address - Street 2:
Practice Address - City:SHEPHERDSTOWN
Practice Address - State:WV
Practice Address - Zip Code:25443-7000
Practice Address - Country:US
Practice Address - Phone:803-960-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty