Individual
JED NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
700 HIGH STREET, WILLIAMSPORT, PA 17701-3100
(570) 321-2020
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
(570) 326-8723
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP031316
PA
Other
Enumeration date
10/22/2018
Last updated
02/07/2025
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