Provider Demographics
NPI:1548493711
Name:SHANTA, SANTEE N (CASE MANAGER)
Entity type:Individual
Prefix:MRS
First Name:SANTEE
Middle Name:N
Last Name:SHANTA
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MARIPOSA PL APT A13
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-5301
Mailing Address - Country:US
Mailing Address - Phone:505-999-0559
Mailing Address - Fax:
Practice Address - Street 1:704 ZUNI ST
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-5162
Practice Address - Country:US
Practice Address - Phone:575-751-7552
Practice Address - Fax:575-751-7718
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator