Individual
MS. REA MAE SANTIAGO AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
167 NORTH MAIN STREET, TUBA CITY, AZ 86045-0600
(928) 283-2525
Mailing address
167 NORTH MAIN STREET, PO BOX 600, TUBA CITY, AZ 86045
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R191198
MD
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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