Sandra M. Nettina, C.R.N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R109061 Issued in MD

Practice address

2760 Wynfield Rd
West Friendship, MD 21794-9519

Phone

(410) 336-3385

Fax

(410) 489-5169

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407880131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 WYNFIELD RD",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217949519",
            "telephone_number": "410-336-3385",
            "fax_number": "410-489-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 WYNFIELD RD",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217949519",
            "telephone_number": "410-336-3385",
            "fax_number": "410-489-5169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5450 Knoll North Dr",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210452300",
            "country_code": "US",
            "telephone_number": "410-964-6200",
            "fax_number": "410-964-6392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NETTINA",
        "first_name": "SANDRA",
        "middle_name": "M.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R109061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen M. Green, P.T.
• Rizwan Lakhani, L. AC., M. AC.
• Maryland Autism Services, LLC
• Hindia Mohammed
• Clark Raymond Mollenhoff III, M.AC., L.AC.
• Julia Ann Oriani, RD, PHD
• Prime Care House Calls PC
• Judith Roark, LCPC
• Tom Fenlon DDS PC
• Lisa Madoff Townsend

• Adult Health Nurse Practitioner in West Friendship, MD
• Providers in West Friendship, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.