Provider Demographics
NPI:1548444870
Name:SANTANA, KRISTIE ANN (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:ANN
Last Name:SANTANA
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:KRISTIE
Other - Middle Name:ANN
Other - Last Name:SANTANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP, PMHNP-BC
Mailing Address - Street 1:1105 LEON ST
Mailing Address - Street 2:ATTN: CLINIC
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3541
Mailing Address - Country:US
Mailing Address - Phone:305-296-5628
Mailing Address - Fax:
Practice Address - Street 1:1200 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4023
Practice Address - Country:US
Practice Address - Phone:305-294-5531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9187314163W00000X
FLAPRN11013099363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse