Healthcare Provider Details

I. General information

NPI: 1962167940
Provider Name (Legal Business Name): DAYANNE SANTOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2021
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 DAN RD STE 125
CANTON MA
02021-2860
US

IV. Provider business mailing address

45 DAN RD STE 125
CANTON MA
02021-2860
US

V. Phone/Fax

Practice location:
  • Phone: 401-680-0411
  • Fax: 401-563-9125
Mailing address:
  • Phone: 401-680-0411
  • Fax: 401-563-9125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2314590
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2314590
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: