Provider Demographics
NPI:1427251859
Name:SANTANA DE LOS SANTOS, JENNIFER MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIA
Last Name:SANTANA DE LOS SANTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:256 SEABOARD LN
Practice Address - Street 2:SUITE F101
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2875
Practice Address - Country:US
Practice Address - Phone:615-628-8064
Practice Address - Fax:877-297-3060
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301087463207R00000X
TN47333207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6046846OtherBCBS
TN1518303692OtherMEDICARE NPI
KY7100358360Medicaid
TNQ014614Medicaid
TNQ014614Medicaid
TN1518303692Medicare PIN