Individual
BARRY G. NIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPNP
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4000
(909) 558-7873
Mailing address
25010 PROSPECT AVE, LOMA LINDA, CA 92354-2900
(909) 796-5634
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN464104
CA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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