Individual
DINO ANTHONY DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP-BC
Contact information
Practice address
1310 24TH AVE S, VA TENNESSEE VALLEY HEALTHCARE SYSTEM, NASHVILLE, TN 37212-2637
(615) 873-7512
(615) 873-7757
Mailing address
1310 24TH AVE S, VA TENNESSEE VALLEY HEALTHCARE SYSTEM, NASHVILLE, TN 37212-2637
(615) 873-7512
(615) 873-7757
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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