Provider Demographics
NPI:1699325373
Name:COUVERTIER, MYRNA
Entity type:Individual
Prefix:
First Name:MYRNA
Middle Name:
Last Name:COUVERTIER
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:AF4 CALLE 34
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8599
Mailing Address - Country:US
Mailing Address - Phone:787-657-4254
Mailing Address - Fax:
Practice Address - Street 1:AF4 CALLE 34
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8599
Practice Address - Country:US
Practice Address - Phone:787-657-4254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider