Healthcare Provider Details

I. General information

NPI: 1316531445
Provider Name (Legal Business Name): JAMELY NIEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MDG OPC 80 BOX 5217
APO AP
96368-5217
US

IV. Provider business mailing address

18 MDG OPC 80 BOX 5217
APO AP
96368-5217
US

V. Phone/Fax

Practice location:
  • Phone: 98-960-4817
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1003X
TaxonomyIndependent Duty Medical Technicians
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: