Individual
SARAH WISCHMEYER NIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A-C
Contact information
Practice address
520 W LINCOLN AVE, SUITE A, ADA, OH 45810-9466
(419) 634-2015
(419) 634-9420
Mailing address
951 COMMERCE PKWY, SUITE 101, LIMA, OH 45804-4040
(419) 998-4575
(419) 998-4586
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.003202
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067924
—
OH
Enumeration date
01/26/2011
Last updated
03/05/2018
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