Provider Demographics
NPI:1477934859
Name:SANTANA, BEVERLY A (CNM)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:A
Last Name:SANTANA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BANNING ST STE 320
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3488
Mailing Address - Country:US
Mailing Address - Phone:302-674-0223
Mailing Address - Fax:
Practice Address - Street 1:200 BANNING ST STE 320
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3488
Practice Address - Country:US
Practice Address - Phone:302-674-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELK-0000178367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife