Individual provider · Type 1 NPI

Talia Marie Nieto

Physician Assistant · Jacksonville, NC

NPI number 1124954375 Active

Practice location

114 Memorial Dr
Jacksonville, NC 28546-6328

Call (910) 353-9688 Map

Mailing address

121 Fox Blvd
Massapequa, NY 11758-7253

Other practice locations

  • 108 Lakeside Dr, Sneads Ferry, NC 28460-9415 · (910) 327-5437

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1124954375

Talia Marie Nieto's National Provider Identifier is 1124954375, issued on Jun 23, 2026. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Jacksonville, NC. The record was last updated on Sep 22, 2026.