Provider Demographics
NPI:1982143335
Name:CANTU SANTOLI, SHANNAN (APNP CNM)
Entity type:Individual
Prefix:
First Name:SHANNAN
Middle Name:
Last Name:CANTU SANTOLI
Suffix:
Gender:F
Credentials:APNP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-4777
Mailing Address - Fax:414-805-4774
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-4777
Practice Address - Fax:414-805-4774
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148990367A00000X
WI148990-32176B00000X
IL209015629367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1982143335Medicaid
WI1000-947-56Medicaid