Provider Demographics
NPI:1629757349
Name:MEDINA-GARCIA, YANAISHA (RN BSN)
Entity Type:Individual
Prefix:
First Name:YANAISHA
Middle Name:
Last Name:MEDINA-GARCIA
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:MISS
Other - First Name:YANAISHA
Other - Middle Name:
Other - Last Name:MEDINA-GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN BSN
Mailing Address - Street 1:PO BOX 141465
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1465
Mailing Address - Country:US
Mailing Address - Phone:939-649-0754
Mailing Address - Fax:
Practice Address - Street 1:CARR. 129 B.O CAMPO ALEGRE KM 8.9
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:939-649-0754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR38377163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy