Provider Demographics
NPI:1558771675
Name:CARRRASQUILLO, CARMEN LOURDES (RN)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:LOURDES
Last Name:CARRRASQUILLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ZZ44 CALLE 25
Mailing Address - Street 2:URB. VILLAS DEL RIO VERDE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-6469
Mailing Address - Country:US
Mailing Address - Phone:817-919-1822
Mailing Address - Fax:
Practice Address - Street 1:ZZ44 CALLE 25
Practice Address - Street 2:VILLAS DEL RIO VERDE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6469
Practice Address - Country:US
Practice Address - Phone:817-919-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR998163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse