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Individual
JENNIFER DEAN NIEWIADOMSKI
Active
Individual
JENNIFER DEAN NIEWIADOMSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50.004437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0145495
—
OH
01
—
H465660
MEDICARE PTAN
OH
Enumeration date
09/28/2015
Last updated
08/08/2023
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