Individual
JESSICA R NILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 WORDEN RD, SCOTIA, NY 12302-3409
(518) 346-0469
Mailing address
30 WORDEN RD, SCOTIA, NY 12302-3409
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
661382-1
NY
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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