Provider Demographics
NPI:1619791662
Name:UMANA, SANDRA LORENA (LPN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LORENA
Last Name:UMANA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 WHITNEY MESA DR # 5589
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2069
Mailing Address - Country:US
Mailing Address - Phone:360-583-3340
Mailing Address - Fax:
Practice Address - Street 1:9474 LATHROP INDUSTRIAL DR SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-1109
Practice Address - Country:US
Practice Address - Phone:360-583-3340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074464164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse