Individual
DIANE K NIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2770 CENTENNIAL RD, 5 NORTH PEDS, TOLEDO, OH 43617-1829
(419) 794-0567
(419) 794-0569
Mailing address
2770 CENTENNIAL RD, TOLEDO, OH 43617-1829
(419) 794-0567
(419) 794-0569
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN205722
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000508160
ANTHEM
OH
05
—
2729659
—
OH
Enumeration date
12/26/2006
Last updated
03/25/2015
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