Provider Demographics
NPI:1851335491
Name:SANTOS, DARCEY LYNNMARIE (PNP)
Entity Type:Individual
Prefix:MRS
First Name:DARCEY
Middle Name:LYNNMARIE
Last Name:SANTOS
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-2721
Mailing Address - Country:US
Mailing Address - Phone:978-988-2039
Mailing Address - Fax:781-944-0232
Practice Address - Street 1:36 WOBURN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2903
Practice Address - Country:US
Practice Address - Phone:781-944-2050
Practice Address - Fax:781-944-0232
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA178254363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP2503OtherBLUE CROSS BLUE SHIELD