Healthcare Provider Details

I. General information

NPI: 1811398134
Provider Name (Legal Business Name): MICHELLE DE LA RIMA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2014
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 CHAPEL HL
EDINBURG TX
78541-0341
US

IV. Provider business mailing address

1410 CHAPEL HL
EDINBURG TX
78541-0341
US

V. Phone/Fax

Practice location:
  • Phone: 956-739-8912
  • Fax:
Mailing address:
  • Phone: 956-739-8912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number748120
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number748120
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: