Provider Demographics
NPI:1992011555
Name:NIEVES-SOTO, BERNABE (RN,MSWAC)
Entity Type:Individual
Prefix:
First Name:BERNABE
Middle Name:
Last Name:NIEVES-SOTO
Suffix:
Gender:M
Credentials:RN,MSWAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 CALLE KIN AVILA
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-2366
Mailing Address - Country:US
Mailing Address - Phone:787-532-4803
Mailing Address - Fax:
Practice Address - Street 1:CARR. 129 ASSMCA ARECIBO
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-3552
Practice Address - Fax:787-879-8633
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR95361041C0700X
PR412163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical