Provider Demographics
NPI:1174253967
Name:NACIONALES, PAULA CRISELDA LEE
Entity Type:Individual
Prefix:
First Name:PAULA CRISELDA
Middle Name:LEE
Last Name:NACIONALES
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 1:217 FOOTHILLS PKWY NE APT 217
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3838
Mailing Address - Country:US
Mailing Address - Phone:615-516-7703
Mailing Address - Fax:
Practice Address - Street 1:217 FOOTHILLS PKWY NE APT 217
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3838
Practice Address - Country:US
Practice Address - Phone:615-516-7703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA297449163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse