Provider Demographics
NPI:1366634222
Name:PENA-FELICIANO, MARIBEL (BSN,RN)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:PENA-FELICIANO
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 446 KM 1.9
Mailing Address - Street 2:BO. GUATEMALA
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-891-2360
Mailing Address - Fax:
Practice Address - Street 1:CARR 446 KM 1.9
Practice Address - Street 2:BO. GUATEMALA
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-891-2360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17381163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse