Provider Demographics
NPI:1124807649
Name:MERCADO NEGRON, ESMIRNA (BSN)
Entity type:Individual
Prefix:
First Name:ESMIRNA
Middle Name:
Last Name:MERCADO NEGRON
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 18 BOX 1390
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9821
Mailing Address - Country:US
Mailing Address - Phone:939-240-6003
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA NEVAREZ
Practice Address - Street 2:1009 CLL 8 APT ALTOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:939-240-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR90054163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice