Healthcare Provider Details

I. General information

NPI: 1114530268
Provider Name (Legal Business Name): EMMA MARIA SANTIAGO-GARCIA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS EMMA MARIA SANTIAGO

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E MARSHALL ST STE W039
WEST CHESTER PA
19380-4412
US

IV. Provider business mailing address

478 GLENN ROSE CIR
KING OF PRUSSIA PA
19406-1798
US

V. Phone/Fax

Practice location:
  • Phone: 610-431-5155
  • Fax: 610-431-5157
Mailing address:
  • Phone: 718-581-6519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP021881
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: