Provider Demographics
NPI:1952713059
Name:SANTIAGO, RACHEL (FNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S SAGE CIR # A
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-2352
Mailing Address - Country:US
Mailing Address - Phone:607-259-9575
Mailing Address - Fax:
Practice Address - Street 1:9900 BREN ROAD EAST
Practice Address - Street 2:MAIL ROUTE MN 008-B213
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-2352
Practice Address - Country:US
Practice Address - Phone:607-377-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY546583-1163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical