Provider Demographics
NPI:1265898886
Name:COLON SIEMER, NICOLE ANDREA (PHARMD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ANDREA
Last Name:COLON SIEMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CALLE SAN ROBERTO STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2758
Mailing Address - Country:US
Mailing Address - Phone:787-705-8544
Mailing Address - Fax:
Practice Address - Street 1:1001 CALLE SAN ROBERTO STE 101
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2758
Practice Address - Country:US
Practice Address - Phone:787-526-7751
Practice Address - Fax:787-705-8544
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist