Individual
JENNIFER NIEBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 STATE ST FL 4, 4TH FLOOR, SUITE 401, ERIE, PA 16507-1427
(814) 877-6111
Mailing address
300 STATE ST FL 4, 4TH FLOOR, SUITE 401, ERIE, PA 16507-1427
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA055776
PA
Other
Enumeration date
09/28/2012
Last updated
04/06/2021
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