Gervacio, Neilrose Laciste

Gervacio, Neilrose Laciste is an individual health care provider with primary practice located at Camp Schwab Bmc 3D Med Bn, 3D Mlg, C Co, Fpo AP 96604. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Gervacio, Neilrose Laciste can be contacted via phone 011816117252272.

Contact Information

Primary practice address
Camp Schwab Bmc 3D Med Bn, 3D Mlg, C Co Fpo AP 96604
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X

Profile Details

NPI number 1063460210
LBN Legal business name Gervacio, Neilrose Laciste
Credentials IDC
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Apr 20th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063460210 NPPES
Other 1710I1002X INDEPENDENT DUTY CORPSMAN

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