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Individual
NICOLE ELLIS NIEMIEC
Active
Individual
NICOLE ELLIS NIEMIEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 15976
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27759-4
BCBS RI
MA
01
—
41177-1
RI BLUE CHIP
MA
01
—
478985
TUFTS
MA
01
—
5437781
CIGNA
MA
01
—
Y68325
BCBS
MA
01
—
Y6932202
PTAN
—
Enumeration date
11/02/2006
Last updated
08/08/2008
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