Provider Demographics
NPI:1740847110
Name:RIOS, MIA (RN)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 JONES AVE APT 406
Mailing Address - Street 2:
Mailing Address - City:BLANCO
Mailing Address - State:TX
Mailing Address - Zip Code:78606-4505
Mailing Address - Country:US
Mailing Address - Phone:818-488-4387
Mailing Address - Fax:
Practice Address - Street 1:8610 N NEW BRAUNFELS AVE STE 405
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6358
Practice Address - Country:US
Practice Address - Phone:210-804-0193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX961388163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health