Individual
KELLY K NIERMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3240 SUNSET BLVD, WEST COLUMBIA, SC 29169-3428
(803) 359-8855
(803) 794-6480
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 733-5969
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
0024173395
VA
363LP0200X
Pediatric Nurse Practitioner
Primary
21241
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21241
—
SC
05
—
NP4742
—
SC
Enumeration date
03/30/2016
Last updated
09/12/2025
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