Provider Demographics
NPI:1598104036
Name:SANTANA, LOURDES CAROLINA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LOURDES
Middle Name:CAROLINA
Last Name:SANTANA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 BISHOP BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1901
Mailing Address - Country:US
Mailing Address - Phone:201-400-8063
Mailing Address - Fax:
Practice Address - Street 1:602 BISHOP BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1901
Practice Address - Country:US
Practice Address - Phone:201-400-8063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06613500164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse