Individual
ELIZABETH BANKES NIEDEREGGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.M.
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 584-4800
(513) 584-0635
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-0001
(513) 585-5505
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
RN229708
OH
163WX0003X
Inpatient Obstetric Registered Nurse
RN229708
OH
367A00000X
Advanced Practice Midwife
Primary
COA 05290 NM
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000379320
BLUE CROSS & BLUE SHIELD
OH
01
—
11508741
CAQH NUMBER
OH
05
—
2507764
—
OH
05
—
292503
—
OH
05
—
310832874
—
OH
05
—
310832874029
—
OH
Enumeration date
08/28/2006
Last updated
11/17/2017
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