Provider Demographics
NPI:1942794250
Name:SANTOS, GUTEMBERGUE ARRUDA (DNP-FNP)
Entity Type:Individual
Prefix:DR
First Name:GUTEMBERGUE
Middle Name:ARRUDA
Last Name:SANTOS
Suffix:
Gender:M
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:GUTEMBERGUE
Other - Middle Name:A
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:105 CENTRAL AVE STE 200A
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-3084
Mailing Address - Country:US
Mailing Address - Phone:843-557-9808
Mailing Address - Fax:843-273-8144
Practice Address - Street 1:105 CENTRAL AVE STE 200A
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-3087
Practice Address - Country:US
Practice Address - Phone:843-557-9808
Practice Address - Fax:843-273-8144
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21971363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily