Healthcare Provider Details

I. General information

NPI: 1760665483
Provider Name (Legal Business Name): CHARLENE YVETTE SANTEE CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 SCHOLL RD
MANSFIELD OH
44907-1571
US

IV. Provider business mailing address

6024 COUNTY ROAD 93
MOUNT GILEAD OH
43338-9572
US

V. Phone/Fax

Practice location:
  • Phone: 419-756-1717
  • Fax:
Mailing address:
  • Phone: 419-947-9205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberNS-09732
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: