Provider Demographics
NPI:1003485194
Name:NIEMEYER, MARISSA CLAIRE (MSN, AGPCNP-C)
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:CLAIRE
Last Name:NIEMEYER
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Gender:F
Credentials:MSN, AGPCNP-C
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Mailing Address - Street 1:10223 US HIGHWAY 281 N STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4664
Mailing Address - Country:US
Mailing Address - Phone:210-338-8800
Mailing Address - Fax:210-338-8825
Practice Address - Street 1:10223 US HIGHWAY 281 N STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4664
Practice Address - Country:US
Practice Address - Phone:210-338-8800
Practice Address - Fax:210-338-8825
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2021-09-27
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Provider Licenses
StateLicense IDTaxonomies
MI4704330088NSA210G9363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care