Provider Demographics
NPI:1518661743
Name:NICOLAS HERRERA, ESMERALDA
Entity Type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:
Last Name:NICOLAS HERRERA
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 1:6001 MONTROSE RD STE 402
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4882
Mailing Address - Country:US
Mailing Address - Phone:251-281-4256
Mailing Address - Fax:
Practice Address - Street 1:6001 MONTROSE RD STE 402
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4882
Practice Address - Country:US
Practice Address - Phone:301-984-6594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program