Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 5010861 | NC |
NPI | 1013497312 |
---|---|
Provider Name | Mrs. Elizabeth Hayes Santiago |
First Address | Winterville, NC 28590-0275 |
Second Address | Greenville, NC 27834-2783 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2018 |
Last Update Date | 27/12/2021 |