Provider Demographics
NPI:1427673870
Name:SANTANIELLO, ALYSON BETH (APRN)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:BETH
Last Name:SANTANIELLO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2209
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-2209
Mailing Address - Country:US
Mailing Address - Phone:603-526-4077
Mailing Address - Fax:603-242-1527
Practice Address - Street 1:107 NEWPORT RD
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:NH
Practice Address - Zip Code:03257-5415
Practice Address - Country:US
Practice Address - Phone:603-526-4077
Practice Address - Fax:603-242-1527
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH069701-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner