Provider Demographics
NPI:1336969534
Name:SANTOS, BERNALYN T (APRN, FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:BERNALYN
Middle Name:T
Last Name:SANTOS
Suffix:
Gender:
Credentials:APRN, FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 E CAREFREE HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-4742
Mailing Address - Country:US
Mailing Address - Phone:804-847-2273
Mailing Address - Fax:480-847-2271
Practice Address - Street 1:4705 E CAREFREE HWY STE 103
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-4742
Practice Address - Country:US
Practice Address - Phone:480-847-2273
Practice Address - Fax:480-847-2271
Is Sole Proprietor?:No
Enumeration Date:2024-10-12
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ231049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily