Provider Demographics
NPI:1538200324
Name:CANUELAS, NANCY
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:CANUELAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 AVE PEDRO ALBIZU CAMPOS
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-5726
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:148 AVE PEDRO ALBIZU CAMPOS
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-5726
Practice Address - Country:US
Practice Address - Phone:787-891-6835
Practice Address - Fax:787-891-6835
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1102231OtherLIC #