Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 0104001369 | VA |
NPI | 1538246533 |
---|---|
Provider Name | Dr. Tamara Gail Santa Ana |
First Address | Lexington, VA 24450-2432 |
Second Address | Lexington, VA 24450-2432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 05/08/2011 |