Provider Demographics
NPI:1982191227
Name:NIEVERAS, ISABEL BALBIN (RN, BSN, MSN)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:BALBIN
Last Name:NIEVERAS
Suffix:
Gender:F
Credentials:RN, BSN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 N SABANA BARRIGADA DR
Mailing Address - Street 2:
Mailing Address - City:BARRIGADA
Mailing Address - State:GU
Mailing Address - Zip Code:96913-1262
Mailing Address - Country:US
Mailing Address - Phone:671-632-9370
Mailing Address - Fax:671-632-1679
Practice Address - Street 1:350 N SABANA BARRIGADA DR
Practice Address - Street 2:
Practice Address - City:BARRIGADA
Practice Address - State:GU
Practice Address - Zip Code:96913-1262
Practice Address - Country:US
Practice Address - Phone:671-632-9370
Practice Address - Fax:671-632-1679
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUR1220163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GU1228050369OtherMEDICALLY INDIGENT PROGRAM (MIP)