Provider Demographics
NPI:1356605224
Name:SANTIAGO, SHEILA (ANP-BC)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3699 US HIGHWAY 46
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1049
Mailing Address - Country:US
Mailing Address - Phone:973-794-6080
Mailing Address - Fax:973-794-6081
Practice Address - Street 1:3699 US HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1049
Practice Address - Country:US
Practice Address - Phone:973-794-6080
Practice Address - Fax:973-794-6081
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00381600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health