Individual
MS. MEGAN SUZANNE NIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3825 EDWARDS RD STE 300, CINCINNATI, OH 45209
(513) 221-1100
(513) 569-5297
Mailing address
PO BOX 643398, CINCINNATI, OH 45264-3398
(513) 221-1100
(513) 569-5297
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02838
NC
363A00000X
Physician Assistant
Primary
50.005423RX
OH
363AM0700X
Medical Physician Assistant
001002838
NC
363AS0400X
Surgical Physician Assistant
50.005423RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901037
—
NC
Enumeration date
03/30/2011
Last updated
05/17/2018
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