Individual
JESSICA NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
MSC 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-9539
(541) 285-1417
Mailing address
MSC 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(541) 285-1417
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
DO2023-1036
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2018
Last updated
07/05/2024
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