Provider Demographics
NPI:1023587300
Name:NIEVES MEDINA, AMAIRY (BSN)
Entity type:Individual
Prefix:
First Name:AMAIRY
Middle Name:
Last Name:NIEVES MEDINA
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB PUERTO NUEVO CALLE ARAGON
Mailing Address - Street 2:BUZON 605
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:787-696-2482
Mailing Address - Fax:
Practice Address - Street 1:URB PUERTO NUEVO CALLE ARAGON
Practice Address - Street 2:BUZON 605
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-696-2482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33515A163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health