MEDICARE: MIGUEL SIERRA GARCIA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ15501900	NJ
2	163W00000X	Registered Nurse	26NR22651800	NJ

General Provider Information

NPI Number	:	1285149856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL SIERRA GARCIA RN

Provider Business Mailing Address
First Line	:	99 GORGE RD APT 1511
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1097
Country	:	US
Telephone Number	:	718-514-4651
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 GORGE RD APT 1511
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1097
Country	:	US
Telephone Number	:	718-514-4651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2017
Last Update Date	:	01/06/2026

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