Provider Demographics
NPI:1245656511
Name:SANTAMOUR, DARLENE (CNP)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:SANTAMOUR
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:DARLENE
Other - Middle Name:
Other - Last Name:SANTAMOUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP
Mailing Address - Street 1:1110 N CHALKVILLE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1083
Mailing Address - Country:US
Mailing Address - Phone:205-655-1092
Mailing Address - Fax:
Practice Address - Street 1:1110 N CHALKVILLE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1083
Practice Address - Country:US
Practice Address - Phone:205-655-1092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL105957363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health