Healthcare Provider Details

I. General information

NPI: 1619653060
Provider Name (Legal Business Name): NIRAIDY NIEVES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1782
US

IV. Provider business mailing address

27401 DETROIT RD APT D20
WESTLAKE OH
44145-2246
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax:
Mailing address:
  • Phone: 216-287-7393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number498997
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: