Provider Demographics
NPI:1790989796
Name:FIGUEROA, BERTHA (LPN)
Entity Type:Individual
Prefix:
First Name:BERTHA
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 SOLANA DRIVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364
Mailing Address - Country:US
Mailing Address - Phone:928-502-5910
Mailing Address - Fax:928-502-5869
Practice Address - Street 1:4100 W 20TH STREET
Practice Address - Street 2:CIBOLA HIGH SCHOOL
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364
Practice Address - Country:US
Practice Address - Phone:928-502-5910
Practice Address - Fax:928-502-5869
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP020525164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse