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General NPI Number Information
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NPI Number | 1629862768
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Entity Type | Individual
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Provider Name | GABRIELA ISABEL NIEVES
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Gender |
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 04/05/2025
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Provider Practice Location Address
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Address Line | 11201 BENTON ST
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City | LOMA LINDA
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State | CA
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Zip | 92357-1000
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Country | US
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Telephone | 909-825-7084
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 194
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City | WEST KINGSTON
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State | RI
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Zip | 02892-0194
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Country | US
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Telephone | 401-654-9199
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH06556
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License Number State | RI
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