Individual
MR. KEVIN NISWONGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
460 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-5000
Mailing address
5562 FREEDOM RUN, ORIENT, OH 43146-9354
(513) 477-1119
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
410600
OH
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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