Provider Demographics
NPI:1811398134
Name:DE LA RIMA, MICHELLE (RN)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:DE LA RIMA
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 1:1410 CHAPEL HL
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-0341
Mailing Address - Country:US
Mailing Address - Phone:956-739-8912
Mailing Address - Fax:
Practice Address - Street 1:1410 CHAPEL HL
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-0341
Practice Address - Country:US
Practice Address - Phone:956-739-8912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-05
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX748120163WR0400X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation