Provider Demographics
NPI:1588958243
Name:COLON, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1679 CALLE VIOLETA
Mailing Address - Street 2:SAN FRANCISCO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6229
Mailing Address - Country:US
Mailing Address - Phone:787-792-3725
Mailing Address - Fax:
Practice Address - Street 1:AVE SAN PATRICIO
Practice Address - Street 2:LOCAL 1 SUITE 1
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-4459
Practice Address - Country:US
Practice Address - Phone:787-792-3725
Practice Address - Fax:787-774-0555
Is Sole Proprietor?:No
Enumeration Date:2011-05-30
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist