Healthcare Provider Details

I. General information

NPI: 1609799774
Provider Name (Legal Business Name): REBECCA CARROLL SANTOS MSN,APRN,PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 FRANKLIN SQUARE DR
BALTIMORE MD
21237-3901
US

IV. Provider business mailing address

9000 FRANKLIN SQUARE DR
BALTIMORE MD
21237-3901
US

V. Phone/Fax

Practice location:
  • Phone: 410-652-1909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR213316
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: