Provider Demographics
NPI:1043429079
Name:NIEVES, IVONNE FABIOLA (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:IVONNE
Middle Name:FABIOLA
Last Name:NIEVES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 TREASURE ST
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-7875
Mailing Address - Country:US
Mailing Address - Phone:850-936-8083
Mailing Address - Fax:
Practice Address - Street 1:7530 TREASURE ST
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7875
Practice Address - Country:US
Practice Address - Phone:850-936-8083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLANT3306292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily