Healthcare Provider Details

I. General information

NPI: 1194577320
Provider Name (Legal Business Name): ANETTE GAIL SANTOS PE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 W THOMAS RD
PHOENIX AZ
85037-3332
US

IV. Provider business mailing address

9201 W THOMAS RD
PHOENIX AZ
85037-3332
US

V. Phone/Fax

Practice location:
  • Phone: 623-327-4000
  • Fax:
Mailing address:
  • Phone: 623-327-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231899
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: