Healthcare Provider Details

I. General information

NPI: 1629757349
Provider Name (Legal Business Name): YANAISHA MEDINA-GARCIA RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YANAISHA MEDINA-GARCIA RN BSN

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 129 B.O CAMPO ALEGRE KM 8.9
HATILLO PR
00659
US

IV. Provider business mailing address

PO BOX 141465
ARECIBO PR
00614-1465
US

V. Phone/Fax

Practice location:
  • Phone: 939-649-0754
  • Fax:
Mailing address:
  • Phone: 939-649-0754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number38377
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: