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Individual

MRS. KATHRYN RUTH DESANTIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN, FNP-BC

Contact information

Practice address
1378 SW DAVID DR, GRANTS PASS, OR 97527-6429
(801) 272-1246
Mailing address
1378 SW DAVID DR, GRANTS PASS, OR 97527-6429
(801) 272-1246

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
02758224405
UT
363LF0000X
Family Nurse Practitioner
02758228900
UT
363LF0000X
Family Nurse Practitioner
0349373
UT
363LF0000X
Family Nurse Practitioner
201603205NP-PP
OR

Other

Enumeration date
08/03/2005
Last updated
04/05/2017
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