Healthcare Provider Details

I. General information

NPI: 1467053298
Provider Name (Legal Business Name): SANTISSA TENISE CLAPP PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANTISSA HARPER PMHNP-BC

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WOODMONT LN NW # 2219
ATLANTA GA
30318-2866
US

IV. Provider business mailing address

1445 WOODMONT LN NW # 2219
ATLANTA GA
30318-2866
US

V. Phone/Fax

Practice location:
  • Phone: 816-372-5279
  • Fax:
Mailing address:
  • Phone: 470-944-5699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number265543
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2021011345
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberGAA-NP000165
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2014036581
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: