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Individual

MS. NICOLE MARIE SANTAVICCA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
0001228588
VA
163WC0200X
Critical Care Medicine Registered Nurse
RN643432
PA
163WC0200X
Critical Care Medicine Registered Nurse
RN9296779
FL
367500000X
Certified Registered Nurse Anesthetist
106817
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
25113
SC

Other

Enumeration date
01/03/2015
Last updated
03/09/2023
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