Provider Demographics
NPI:1891112033
Name:SANTIZO, ALLISON BROOKE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON BROOKE
Middle Name:
Last Name:SANTIZO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:A. BROOKE
Other - Middle Name:
Other - Last Name:AUGESTAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-C
Mailing Address - Street 1:810 SANDERS RD
Mailing Address - Street 2:STE B
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9051
Mailing Address - Country:US
Mailing Address - Phone:770-415-2515
Mailing Address - Fax:770-945-3631
Practice Address - Street 1:810 SANDERS RD STE B
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9051
Practice Address - Country:US
Practice Address - Phone:770-415-2515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN206701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily