Provider Demographics
NPI:1548969801
Name:SANTOS, AMELITA LOPINA (RN)
Entity type:Individual
Prefix:
First Name:AMELITA
Middle Name:LOPINA
Last Name:SANTOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W GEMINI LN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-3317
Mailing Address - Country:US
Mailing Address - Phone:254-702-1640
Mailing Address - Fax:
Practice Address - Street 1:500 W GEMINI LN
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3317
Practice Address - Country:US
Practice Address - Phone:254-702-1640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX639298163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse