Provider Demographics
NPI:1104397512
Name:NIEVES, NANCY (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:NIEVES
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:523-567-0188
Mailing Address - Fax:813-355-5101
Practice Address - Street 1:1721 BRANDON MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5018
Practice Address - Country:US
Practice Address - Phone:813-315-1530
Practice Address - Fax:813-355-5909
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11017543363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily