Provider Demographics
NPI:1972729549
Name:SANTOS, ELIZABETH LEANN (ELIZABETH SANTOS)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:LEANN
Last Name:SANTOS
Suffix:
Gender:F
Credentials:ELIZABETH SANTOS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LEANN
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ELIZABETH SANTOS
Mailing Address - Street 1:3524 E CHAPPARAL WAY
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-8354
Mailing Address - Country:US
Mailing Address - Phone:928-317-9377
Mailing Address - Fax:
Practice Address - Street 1:3524 E CHAPPARAL WAY
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-8354
Practice Address - Country:US
Practice Address - Phone:928-317-9377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN060556163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool