Nicolle Michelle Rivera- Medina
Individual provider Active NPI Pharmacist · Jayuya, PR
NPI 1407345366 · NPPES record last updated May 7, 2018
Key facts
- NPI
- 1407345366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 006513 (PR)
- Practice address
- Calle Guillermo Esteves 103
Jayuya, PR 00664 - Phone
- (787) 828-0755
- NPI assigned
- May 7, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006513 | PR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 006513 | PR | Yes |
Addresses
Primary practice location
Calle Guillermo Esteves 103
Jayuya, PR 00664
Mailing address
Alts. de Borinquen
6219 Calle Buren
Jayuya, PR 00664-9500
Other providers in Jayuya, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.