Provider Demographics
NPI:1346139961
Name:SANTIAGO, ELVIA LINNETTE (FNP)
Entity type:Individual
Prefix:
First Name:ELVIA
Middle Name:LINNETTE
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 OLDE OAK DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-5648
Mailing Address - Country:US
Mailing Address - Phone:404-789-4366
Mailing Address - Fax:
Practice Address - Street 1:1001 VIRGINIA AVE STE 150
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1373
Practice Address - Country:US
Practice Address - Phone:404-789-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN295100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner