Healthcare Provider Details

I. General information

NPI: 1932003399
Provider Name (Legal Business Name): ABBY DE SANTIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 BREMO RD, MOBN STE 403
RICHMOND VA
23226
US

IV. Provider business mailing address

116 LARNE AVENUE
RICHMOND VA
23224
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-2673
  • Fax:
Mailing address:
  • Phone: 804-651-6667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number0001297973
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: