Individual
JAMES L NIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
100 PROGRESSIVE DR, COLUMBUS GROVE, OH 45830-9620
(419) 659-6010
(419) 659-6012
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-6930
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.15991-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H376411
—
OH
Enumeration date
06/24/2014
Last updated
04/25/2016
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