Provider Demographics
NPI:1952878746
Name:SANTOS-NICHOL, MARIA SHERISSE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:SHERISSE
Last Name:SANTOS-NICHOL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHERISSE
Other - Middle Name:
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:13610 1ST AVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98168
Mailing Address - Country:US
Mailing Address - Phone:206-248-5020
Mailing Address - Fax:206-244-8425
Practice Address - Street 1:13610 1ST AVE SOUTH
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98168
Practice Address - Country:US
Practice Address - Phone:206-248-5020
Practice Address - Fax:206-244-8425
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60783977363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner