Healthcare Provider Details
I. General information
NPI: 1942298815
Provider Name (Legal Business Name): ENGA M. SANTMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/13/2005
Last Update Date: 01/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1900 PINE ST
ABILENE TX
79601-2432
US
IV. Provider business mailing address
PO BOX 676240
DALLAS TX
75267-6240
US
V. Phone/Fax
- Phone: 325-670-2151
- Fax:
- Phone: 866-321-8433
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 702015 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | NP-10315 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: