Provider Demographics
NPI:1346023124
Name:SANTOS, DESIREE LYNN (RN)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:LYNN
Last Name:SANTOS
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 1:40 HOLLYHOCK ST # 1
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-1207
Mailing Address - Country:US
Mailing Address - Phone:508-971-6842
Mailing Address - Fax:
Practice Address - Street 1:170 PLEASANT ST STE 100
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3015
Practice Address - Country:US
Practice Address - Phone:774-294-5722
Practice Address - Fax:774-294-5724
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program