Provider Demographics
NPI:1346008117
Name:SAMPILO, ELEANOR SANTOS (RN)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:SANTOS
Last Name:SAMPILO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BLACKBERRY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5646
Mailing Address - Country:US
Mailing Address - Phone:301-643-8788
Mailing Address - Fax:
Practice Address - Street 1:200 BLACKBERRY DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5646
Practice Address - Country:US
Practice Address - Phone:301-643-8788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR106502163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse