Provider Demographics
NPI:1285889972
Name:SANTARELLI, ANGIE M (APNP)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:M
Last Name:SANTARELLI
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:M
Other - Last Name:COTTONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:PO BOX 689711
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53268-9711
Mailing Address - Country:US
Mailing Address - Phone:414-456-3100
Mailing Address - Fax:414-456-3113
Practice Address - Street 1:201 N MAYFAIR RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4216
Practice Address - Country:US
Practice Address - Phone:414-259-7575
Practice Address - Fax:414-259-7566
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3524363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner