Provider Demographics
NPI:1669071296
Name:SANTOS LU, JESSICA MARTINS (DNP, FNP-C, ENP-C)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARTINS
Last Name:SANTOS LU
Suffix:
Gender:F
Credentials:DNP, FNP-C, ENP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3850
Mailing Address - Country:US
Mailing Address - Phone:908-764-8749
Mailing Address - Fax:
Practice Address - Street 1:418 NJ-18
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-613-6168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-24
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily