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NPI Code Detail

MEDICARE: EDGAR ANTHONY SANTILLAN

MEDICARE: EDGAR ANTHONY SANTILLAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376J00000XHomemaker

General Provider Information

NPI Number : 1447050166
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGAR ANTHONY SANTILLAN
Provider Business Mailing Address
First Line : 211 W NORFOLK AVE
Second Line :
City : NORFOLK
State : NE
Zip : 68701-5341
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 211 W NORFOLK AVE
Second Line :
City : NORFOLK
State : NE
Zip : 68701-5341
Country : US
Telephone Number : 402-379-8225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2025
Last Update Date : 03/13/2025

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Directions to “ EDGAR ANTHONY SANTILLAN ” Practice Location

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