MR. NEILROSE LACISTE GERVACIO (NPI# 1063460210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063460210 |
Entity Type | Individual |
Full Name | MR. NEILROSE LACISTE GERVACIO |
Credential | IDC |
Practice Address |
Camp Schwab Bmc 3d Med Bn, 3d Mlg, C Co Fpo AP 96604 |
Mailing Address |
Psc 557 Box 2631 Fpo AP 96379 |
Practice Telephone | 011816117252272 |
Enumeration Date | 2006-05-04 |
Last Update Date | 2008-04-20 |
Gender Code | M |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
INDEPENDENT DUTY CORPSMAN | 1710I1002X | 01 |
Street Address |
CAMP SCHWAB BMC 3D MED BN, 3D MLG, C CO |
City | FPO |
State | AP |
Zip Code | 96604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114254448 | Hector Joel Silva | Military Health Care Provider | 3med Bn 3mlg H&s Co. Unit 38447, Fpo, AP 96604 | 2009-11-06 |
1922203611 | Lorenzo F Basilio IIi | Military Health Care Provider | 3d Medical Bn, Bravo Company, Camp Hansen, OKINAWA 96604 | 2007-06-20 |
1508061292 | Jeremy S Covell | Military Health Care Provider | 3rd Med Bn 3rd Fssg, Bravo Co Unit 38448, Fpo, AP 96604 | 2007-06-20 |
1629132501 | Michael Adam Ravens | Dentist | 3d Dental Battalion, Unit 38450, Fpo, AP 96604 | 2006-12-21 |
1669535936 | Faron Michael Uebelacker | Military Health Care Provider | 3d Med Bn 3d Mlg, Unit 38449, Fpo, AP 96604 | 2006-12-18 |
1659474229 | Rachel Miyoko Anderson | Dentist | 3d Denbn/usndc, Unit 38450, Fpo, AP 96604 | 2006-09-07 |
1093795247 | Douglas Scott Trenor | Dentist | 3d Den Bn/usndc, 3mlg, Detc, Unit 88452, Fpo, AP 96604 | 2006-01-21 |
1346529559 | Ujval Reddy Gummi | Dentist | 3d Dental Battalion/usndc Okinawa, Unit 38450, Fpo, AP 96604 | 2011-08-05 |
1962492447 | Jeffrey Nils Korsnes | Dentist | 3d Dental Battalion/us Naval Dental Denter, 3d Mlg, Camp Hansen, Unit 38452, Fpo, AP 96604-0259 | 2005-10-25 |
1992251763 | Jackson Dehn | Military Health Care Provider | 3rd Marine Logistics Group, Unit 38404, Fpo, AP 96604-8404 | 2016-08-31 |
Find all providers in zip 96604 |
Taxonomy Code | 1710I1002X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Corpsman |
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538768833 | James Blake Weldon | Military Health Care Provider | Unit 100517 Bx 1, Fpo, AP 09655 | 2020-10-19 |
1740803279 | Issa Khalil | Military Health Care Provider | Uss Donald Cook, Fpo, AE 09566 | 2020-05-19 |
1396370623 | Daniel Rocha Moy | Military Health Care Provider | Uss Thunderbolt (pc-12), Fpo, AE 09588 | 2020-03-06 |
1639701634 | Stephen Henderson | Military Health Care Provider | 3d Recon Bn, Force Co., Unit 36180, Fpo, AP 96389-6180 | 2020-02-07 |
1649810219 | Maxwell Onyedikachi Osisioma | Military Health Care Provider | Psd-18, Macg-18, 1st Maw Unit 37172, Fpo, AP 96372 | 2020-01-13 |
1508406273 | Daniel Levin | Military Health Care Provider | 3d Recon Bn Aid Station, Fpo, AP 96389-6189 | 2020-01-10 |
1053955609 | Christopher Zartman | Military Health Care Provider | Camp Foster, Okinawa Japan, Fpo, AP 96379-0005 | 2019-11-06 |
1912553975 | Brandon Joseph Dapper | Military Health Care Provider | Camp Lejeune, Nc, 2d Reconnaissance Battalion Battalion Aid Station, Fpo, AA 28542-0138 | 2019-08-15 |
1518525583 | William Edward Mcbreen Jr. | Military Health Care Provider | Coastal Riverine Group 1 Detachment Guam, Fpo, AP 96540-1400 | 2019-06-04 |
1558832345 | Nathaniel Franklin Campbell | Military Health Care Provider | Rr 612 Everett Creek Rd, Camp Lejuene, Fpo, AE 28542 | 2018-12-06 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.