Provider Demographics
NPI:1962612911
Name:NIEVES, NANCY L (RPH)
Entity type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:L
Last Name:NIEVES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:L
Other - Last Name:NIEVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:PO BOX 481
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-0481
Mailing Address - Country:US
Mailing Address - Phone:787-869-7220
Mailing Address - Fax:
Practice Address - Street 1:CALLE GEORGETTI #91
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist