Provider Demographics
NPI: | 1568790533 |
---|---|
Name: | SANTAYANA, JULIE B (CRNP) |
Entity type: | Individual |
Prefix: | |
First Name: | JULIE |
Middle Name: | B |
Last Name: | SANTAYANA |
Suffix: | |
Gender: | F |
Credentials: | CRNP |
Other - Prefix: | |
Other - First Name: | JULIE |
Other - Middle Name: | B |
Other - Last Name: | SCHAEFFER |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | |
Mailing Address - Street 1: | 1605 N CEDAR CREST BLVD STE 411 |
Mailing Address - Street 2: | |
Mailing Address - City: | ALLENTOWN |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18104-2323 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 610-969-1914 |
Mailing Address - Fax: | 610-969-3951 |
Practice Address - Street 1: | 2545 SCHOENERSVILLE RD |
Practice Address - Street 2: | 5TH FL LVH-M SOUTH |
Practice Address - City: | BETHLEHEM |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18017-7300 |
Practice Address - Country: | US |
Practice Address - Phone: | 484-884-6503 |
Practice Address - Fax: | 484-884-6504 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-12-02 |
Last Update Date: | 2020-04-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | SP010544 | 363LF0000X |
PA | SP015354 | 363LP0808X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |