Provider Demographics
NPI:1528018926
Name:SANTINI, JEANEAN LOUISE (RN)
Entity Type:Individual
Prefix:MS
First Name:JEANEAN
Middle Name:LOUISE
Last Name:SANTINI
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:E5382 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-9342
Mailing Address - Country:US
Mailing Address - Phone:906-932-0822
Mailing Address - Fax:
Practice Address - Street 1:E5382 SUNSET RD
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-9342
Practice Address - Country:US
Practice Address - Phone:906-932-0822
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704 188821163W00000X
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38241000Medicaid