Provider Demographics
NPI:1932292513
Name:NIETO, KEISHA YEMA (MD)
Entity Type:Individual
Prefix:DR
First Name:KEISHA
Middle Name:YEMA
Last Name:NIETO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KEISHA
Other - Middle Name:YEMA
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8901 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5600
Mailing Address - Country:US
Mailing Address - Phone:301-295-5552
Mailing Address - Fax:
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-4001
Practice Address - Fax:703-776-7113
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088639207V00000X
VA0101276098207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology