Provider Demographics
NPI:1750130167
Name:NIEVES, PAULINE STEPHANIE
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:STEPHANIE
Last Name:NIEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 RICHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:ME
Mailing Address - Zip Code:04084-5616
Mailing Address - Country:US
Mailing Address - Phone:207-401-1577
Mailing Address - Fax:
Practice Address - Street 1:923 RICHVILLE RD
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:ME
Practice Address - Zip Code:04084-5616
Practice Address - Country:US
Practice Address - Phone:207-401-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management