Amanda Nieves
General Practice in Yokosuka, KANAGAWA. Individual provider (NPI-1).
NPI number1417606302
StatusActive
Last updated in NPPESOct 26, 2023
Details
- NPI
- 1417606302
- Entity type
- Individual (NPI-1)
- Name
- Amanda Nieves
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2022
- Certification date
- Oct 26, 2023
- Last updated
- Oct 26, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - EMERGENCY MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 0101279604 | VA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
82 InaokachoYokosuka, KANAGAWA 2380002
JP
Phone 315-241-8038
Mailing address
Psc 473 Box 47Fpo, AP 96349-0001
Phone 315-241-8038
Other practice locations
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Portsmouth, VA 23708-2111
Phone 757-953-0669
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