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General NPI Number Information
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NPI Number | 1780476648
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Entity Type | Individual
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Provider Name | JENNA ISABELLA SANTORO
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Gender | Female
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 800 OAK RIDGE TPKE
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City | OAK RIDGE
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State | TN
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Zip | 37830-6957
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Country | US
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Telephone | 865-483-1093
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Fax |
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Provider Business Mailing Address
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Address Line | 6811 LEWIS RD
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City | BALDWIN
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State | MD
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Zip | 21013-9335
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Country | US
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Telephone | 410-499-0170
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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