Provider Demographics
NPI:1235891433
Name:SANTARSIERO, DESIRAE ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:DESIRAE
Middle Name:ANN
Last Name:SANTARSIERO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SUPREME CT
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-6800
Mailing Address - Country:US
Mailing Address - Phone:570-702-3270
Mailing Address - Fax:
Practice Address - Street 1:420 SUPREME CT
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302-6800
Practice Address - Country:US
Practice Address - Phone:570-702-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily