Provider Demographics
NPI:1962653584
Name:NISHI, LOURDES EMIKO
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:EMIKO
Last Name:NISHI
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 1:2600 OAKSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-5671
Mailing Address - Country:US
Mailing Address - Phone:719-295-0100
Mailing Address - Fax:
Practice Address - Street 1:2600 OAKSHIRE LN
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-5671
Practice Address - Country:US
Practice Address - Phone:719-295-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker