Individual
NICOLE LEIGH NIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3028 NAVARRE AVE, OREGON, OH 43616-3308
(419) 697-6850
(419) 697-6861
Mailing address
232 N WYNN RD, OREGON, OH 43616-1542
(304) 532-0943
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004102
OH
Other
Enumeration date
09/15/2014
Last updated
02/08/2021
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