Provider Demographics
NPI:1235806399
Name:SANTOS, IOLANTE (NP-C)
Entity Type:Individual
Prefix:
First Name:IOLANTE
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 BASILICA LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5136
Mailing Address - Country:US
Mailing Address - Phone:142-914-5228
Mailing Address - Fax:
Practice Address - Street 1:3004 CICKETT DR.
Practice Address - Street 2:3004 CRICKETT DR.
Practice Address - City:PLNO
Practice Address - State:TX
Practice Address - Zip Code:75023
Practice Address - Country:US
Practice Address - Phone:469-756-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049020363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology