Provider Demographics
NPI:1851502975
Name:DIAZ, NILSA J (BSN)
Entity type:Individual
Prefix:MRS
First Name:NILSA
Middle Name:J
Last Name:DIAZ
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:HC-03 BOX 8326 BO. CENTRO
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676
Mailing Address - Country:US
Mailing Address - Phone:787-312-8446
Mailing Address - Fax:
Practice Address - Street 1:CALLE BARBOSA 241
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-4743
Practice Address - Fax:787-877-4744
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19719163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse