Healthcare Provider Details

I. General information

NPI: 1063644094
Provider Name (Legal Business Name): KRISTA KAY NIEVES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2009
Last Update Date: 11/20/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 S MILITARY TRL STE 208
DELRAY BEACH FL
33484-2654
US

IV. Provider business mailing address

22718 HORSESHOE WAY
BOCA RATON FL
33428-5505
US

V. Phone/Fax

Practice location:
  • Phone: 561-563-7110
  • Fax:
Mailing address:
  • Phone: 561-558-0654
  • Fax: 561-892-6332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9166150
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9166150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: