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General NPI Number Information
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NPI Number | 1861471518
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Entity Type | Individual
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Provider Name | TIMOTHY ANDREW SANTANA CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 05/03/2010
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Provider Practice Location Address
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Address Line | 1110 PROFESSIONAL CT
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5826
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Country | US
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Telephone | 240-420-5559
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Fax | 240-420-3786
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Provider Business Mailing Address
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Address Line | PO BOX 790058
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City | SAINT LOUIS
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State | MO
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Zip | 63179-0058
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Country | US
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Telephone | 636-549-2380
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Fax | 314-569-5974
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 244446
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 49407
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R176827
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License Number State | MD
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