1568446102 NPI number — MRS. LOURDES SANCHEZ PRACTICAL NURSE

Table of content: MRS. LOURDES SANCHEZ PRACTICAL NURSE (NPI 1568446102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568446102 NPI number — MRS. LOURDES SANCHEZ PRACTICAL NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANCHEZ
Provider First Name:
LOURDES
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PRACTICAL NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568446102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 930-0329
Provider Second Line Business Mailing Address:
RIO PIEDRAS
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-767-7676
Provider Business Mailing Address Fax Number:
787-764-9904

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE 65 INFANTERIA KU 34
Provider Second Line Business Practice Location Address:
BARRIO SABANA FLANA
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-767-7626
Provider Business Practice Location Address Fax Number:
787-764-9904
Provider Enumeration Date:
12/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , with the licence number:  30860 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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