Provider Demographics
NPI:1972770493
Name:SANTIAGO-KELLEY, PAULA (BSN, RN, CDE)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:SANTIAGO-KELLEY
Suffix:
Gender:F
Credentials:BSN, RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 NORTHAMPTON ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2028
Mailing Address - Country:US
Mailing Address - Phone:413-552-0899
Mailing Address - Fax:413-552-0890
Practice Address - Street 1:1850 NORTHAMPTON ST
Practice Address - Street 2:SUITE 212
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2028
Practice Address - Country:US
Practice Address - Phone:413-552-0899
Practice Address - Fax:413-552-0890
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233459163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator