Provider Demographics
NPI:1770283020
Name:CROUSE-MURRAIN, SANTANA ALYCE (NP)
Entity type:Individual
Prefix:
First Name:SANTANA
Middle Name:ALYCE
Last Name:CROUSE-MURRAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SANTANA
Other - Middle Name:ALYCE
Other - Last Name:CROUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 COLISEUM DR STE 445
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5981
Mailing Address - Country:US
Mailing Address - Phone:757-827-2127
Mailing Address - Fax:
Practice Address - Street 1:4000 COLISEUM DR STE 445
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5981
Practice Address - Country:US
Practice Address - Phone:757-827-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185741363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care