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Individual

DINO ANTHONY DESANTIS

Active
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Individual

DINO ANTHONY DESANTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ACNP-BC

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6075P
KY
363LA2100X
Acute Care Nurse Practitioner
Primary
13167
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000622722
ANTHEM
KY
01
000028412Q
HUMANA
KY
01
106553
SIHO
KY
05
200966480
IN
01
3744147000
PASSPORT ADVANTAGE
KY
01
50026174
PASSPORT
KY
05
7100088140
KY
01
9038116
CIGNA
KY
Enumeration date
01/15/2008
Last updated
06/28/2011
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