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NPI Code Detail

MEDICARE: KELLY SANTOS APRN, CNP

MEDICARE: KELLY SANTOS APRN, CNP
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 PractitionerRN2325826MA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN05129MA
3363LP0808XPsychiatric/Mental Health Nurse PractitionerRN2325826MA
4363LF0000XFamily Nurse PractitionerAPRN03727RI

General Provider Information

NPI Number : 1558044164
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY SANTOS APRN, CNP
Provider Business Mailing Address
First Line : 308 EASTVIEW AVE
Second Line :
City : SOMERSET
State : MA
Zip : 02726-4800
Country : US
Telephone Number : 508-244-9731
Fax Number : 774-307-9039
Provider Business Practice Location Address
First Line : 301 STATE AVE
Second Line :
City : TIVERTON
State : RI
Zip : 02878-1062
Country : US
Telephone Number : 774-300-3444
Fax Number : 774-307-9039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2023
Last Update Date : 04/07/2026

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