Provider Demographics
NPI:1073814786
Name:SANTIAGO, ERIN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2836
Mailing Address - Country:US
Mailing Address - Phone:321-637-2345
Mailing Address - Fax:
Practice Address - Street 1:1133 SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2836
Practice Address - Country:US
Practice Address - Phone:321-637-2345
Practice Address - Fax:321-637-2349
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily