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NPI Code Detail

MEDICARE: MRS. NICOLE R SANTELIA ARNP FNP-C

MEDICARE:  MRS. NICOLE R SANTELIA  ARNP FNP-C
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
1363LF0000XFamily Nurse Practitioner208370GA
2363LF0000XFamily Nurse Practitioner9182275FL

General Provider Information

NPI Number : 1548587462
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NICOLE R SANTELIA ARNP FNP-C
Provider Business Mailing Address
First Line : 1075 BAGWELL DR NW
Second Line :
City : KENNESAW
State : GA
Zip : 30152-7834
Country : US
Telephone Number : 954-854-9339
Fax Number :
Provider Business Practice Location Address
First Line : 3905 DUE WEST RD NW
Second Line :
City : MARIETTA
State : GA
Zip : 30064-1019
Country : US
Telephone Number : 678-290-5740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2010
Last Update Date : 11/02/2010

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Directions to “ MRS. NICOLE R SANTELIA ARNP FNP-C” Practice Location

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