MEDICARE: MRS. KIMBERLY NIEVES FNP-BC

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	363L00000X	Nurse Practitioner	F334164	NY
2	363LF0000X	Family Nurse Practitioner	NP200003452	DC
3	363LF0000X	Family Nurse Practitioner	R216543	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497799365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY NIEVES FNP-BC

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3628
Country	:	US
Telephone Number	:	415-658-6791
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 MEETING ST
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-2375
Country	:	US
Telephone Number	:	888-663-6331
Fax Number	:	415-252-7176

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/17/2025

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