Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

TALIA MARIE NIETO
NPI 1124954375
Physician Assistant - Medical in Jacksonville, NC

Active since June 23, 2026
114 MEMORIAL DR, JACKSONVILLE, NC 28546(910) 353-9688 Get Directions Write a Review

NPPES record added: June 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Talia Marie Nieto NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TALIA MARIE NIETO (NPI 1124954375) is an individual medical provider in Jacksonville, North Carolina and active in the NPI registry since June 2026. She maintains a secondary practice location in Sneads Ferry.

NPPES Registry Identity

NPI1124954375
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameTALIA MARIE NIETO
Location Address114 MEMORIAL DRJacksonville, NC 28546-6328
Mailing Address121 Fox BlvdMassapequa, NY 11758-7253
Sole ProprietorNo
Enumeration DateJune 23, 2026
NPPES CertifiedJune 23, 2026
NPI 1124954375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
114 MEMORIAL DR, Jacksonville, NC 28546

Secondary Practice Location 1

Location 1108 Lakeside DrSneads Ferry, NC 28460-9415 · Phone (910) 327-5437

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacy (Community/Retail Pharmacy)
114 MEMORIAL DR, SUITE B
JACKSONVILLE, NC 28546

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Talia Nieto's NPI number?

The NPI number for Talia Nieto is 1124954375. It was assigned to this individual provider in the NPPES registry on June 23, 2026.

Where is Talia Nieto located?

Talia Nieto practices at 114 Memorial Dr, Jacksonville, NC 28546. The listed phone number is (910) 353-9688.

What is Talia Nieto's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Talia Nieto was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 44 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.