Provider Demographics
NPI:1457685372
Name:SANTANA, ANCA STEFANIA (PA)
Entity Type:Individual
Prefix:MS
First Name:ANCA
Middle Name:STEFANIA
Last Name:SANTANA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANCA
Other - Middle Name:STEFANIA
Other - Last Name:KOVACS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3126 SUNNYCREEK CT
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-9026
Mailing Address - Country:US
Mailing Address - Phone:541-738-1516
Mailing Address - Fax:541-738-1519
Practice Address - Street 1:3126 SUNNYCREEK CT
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-9026
Practice Address - Country:US
Practice Address - Phone:541-738-1516
Practice Address - Fax:541-738-1519
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7339363AS0400X
NY029955363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical