Provider Demographics
NPI:1497818181
Name:DESANTO, CATHY ANNE (ANP)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:ANNE
Last Name:DESANTO
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LOUDEN LP
Mailing Address - Street 2:NO. 251
Mailing Address - City:GALENA
Mailing Address - State:AK
Mailing Address - Zip Code:99741-0000
Mailing Address - Country:US
Mailing Address - Phone:907-656-2236
Mailing Address - Fax:907-656-1525
Practice Address - Street 1:77 ANTOSKI AVE
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:AK
Practice Address - Zip Code:99741-0000
Practice Address - Country:US
Practice Address - Phone:907-656-2489
Practice Address - Fax:907-656-1525
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily