Healthcare Provider Details

I. General information

NPI: 1982191227
Provider Name (Legal Business Name): ISABEL BALBIN NIEVERAS RN, BSN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2018
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N SABANA BARRIGADA DR
BARRIGADA GU
96913-1262
US

IV. Provider business mailing address

350 N SABANA BARRIGADA DR
BARRIGADA GU
96913-1262
US

V. Phone/Fax

Practice location:
  • Phone: 671-632-9370
  • Fax: 671-632-1679
Mailing address:
  • Phone: 671-632-9370
  • Fax: 671-632-1679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR1220
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: