Provider Demographics
NPI:1861772402
Name:SAUNDERS, MARA ANNE (RN, NP)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:ANNE
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 BLEECKER ST # 151
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2410
Mailing Address - Country:US
Mailing Address - Phone:302-313-1584
Mailing Address - Fax:
Practice Address - Street 1:64 BLEECKER ST # 151
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2410
Practice Address - Country:US
Practice Address - Phone:302-313-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015498363LA2200X
CA683207163W00000X
CA20615363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse