Provider Demographics
NPI:1417357401
Name:NAZARIO, YERIKA MARY
Entity Type:Individual
Prefix:MS
First Name:YERIKA
Middle Name:MARY
Last Name:NAZARIO
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:HC 1 BOX 31107
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9742
Mailing Address - Country:US
Mailing Address - Phone:787-284-5884
Mailing Address - Fax:787-284-5874
Practice Address - Street 1:8169 CALLE CONCORDIA STE 412
Practice Address - Street 2:CLINICA ARRARAT
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1567
Practice Address - Country:US
Practice Address - Phone:787-284-5884
Practice Address - Fax:787-284-5874
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR72845163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse