Provider Demographics
NPI:1770351637
Name:COLON FERNANDEZ, ROSED NICOLE (RN)
Entity type:Individual
Prefix:
First Name:ROSED
Middle Name:NICOLE
Last Name:COLON FERNANDEZ
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:PO BOX 1776
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-4776
Mailing Address - Country:US
Mailing Address - Phone:787-673-6749
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 5559 KM 1.5 INTERIOR
Practice Address - Street 2:SECTOR SAN IDELFONSO
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-673-6749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR99741163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse