Provider Demographics
NPI:1518402072
Name:SANTORE, REBECCA MICHELLE (RN)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:MICHELLE
Last Name:SANTORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:MICHELLE
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:HARTLY
Mailing Address - State:DE
Mailing Address - Zip Code:19953-0323
Mailing Address - Country:US
Mailing Address - Phone:610-800-1881
Mailing Address - Fax:
Practice Address - Street 1:424 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1462
Practice Address - Country:US
Practice Address - Phone:302-645-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN640057163W00000X
DEL1-0042691163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse