Provider Demographics
NPI:1659989143
Name:SANTOS, BRIGITTE MARIA
Entity Type:Individual
Prefix:MRS
First Name:BRIGITTE
Middle Name:MARIA
Last Name:SANTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 HARCOURT RD
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-2246
Mailing Address - Country:US
Mailing Address - Phone:904-477-4492
Mailing Address - Fax:
Practice Address - Street 1:188 HARCOURT RD
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-2246
Practice Address - Country:US
Practice Address - Phone:904-477-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN387774163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse