Elizabeth Anne Desantis, WHNP

Primary specialty

Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X

License

2374 Issued in SC

Practice address

2830 Oak St
Conway, SC 29526-4560

Phone

(843) 365-3126

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114940780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1973 MEADOWOOD LN",
            "city": "LONGS",
            "state": "SC",
            "postal_code": "295686527",
            "telephone_number": "843-399-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 OAK ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264560",
            "telephone_number": "843-365-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "SC",
            "license": "2374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISENCE",
            "identifier": "2374",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Russell L Derrick, MD
• Michael Paul Desire
• Cara Detrie, DO
• Agnes Devenyi, MD
• Austin Blake Clark Dew III, PHARMD
• Stephen Dew, PHARMD

• Ambulatory Women's Health Care Registered Nurse in Conway, SC
• Providers in Conway, SC by specialty
• Ambulatory Women's Health Care Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.