Provider Demographics
NPI:1497545966
Name:DE SANTIAGO, CHRISTINA MARIA (LVN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIA
Last Name:DE SANTIAGO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8603 BASIL BRK
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-4080
Mailing Address - Country:US
Mailing Address - Phone:575-495-0400
Mailing Address - Fax:
Practice Address - Street 1:8603 BASIL BRK
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-4080
Practice Address - Country:US
Practice Address - Phone:575-495-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347731164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse