Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 39452 | KY |
Y | 207V00000X | Obstetrician & Gynecologist | 39452 | KY |
NPI | 1700870078 |
---|---|
Provider Name | Dr. Joanna L Santiesteban |
First Address | Prestonsburg, KY 41653-0280 |
Second Address | Salyersville, KY 41465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 17/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64101942 | (05) | KY |
H39282 | (02) |