Basic Information
| Provider Information | |||||||||
| NPI: | 1821687013 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTRY | ||||||||
| FirstName: | AILEEN | ||||||||
| MiddleName: | ROSE | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2722 13TH ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200095316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193453685 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 NEW JERSEY AVE SE STE 500 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200033326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024694699 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2021 | ||||||||
| LastUpdateDate: | 01/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN1034444 | DC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.