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General NPI Number Information
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NPI Number | 1366077562
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Entity Type | Individual
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Provider Name | SANTRICE PLEASANT CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2020
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 245 GOVERNORS DR SE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-2700
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Country | US
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Telephone | 256-265-7061
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Fax |
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Provider Business Mailing Address
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Address Line | 94 CHANDLER LN
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City | TROY
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State | AL
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Zip | 36079-5764
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 1-119564
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1-119564
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License Number State | AL
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