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Organization

NIESE FAMILY MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ZACHARY CHARLES NIESE MSN, APRN, FNP-C (OWNER)
(419) 615-2983
Entity
Organization

Contact information

Practice address
3387 ROAD K3, OTTAWA, OH 45875-8741
(419) 615-2983
Mailing address
2040 ROAD P, PANDORA, OH 45877-9733
(419) 615-2983

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2497822501
OH
Enumeration date
02/02/2021
Last updated
09/27/2023
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