Provider Demographics
NPI:1073780987
Name:NIENABER, JU HSIEN JODI CHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JU HSIEN
Middle Name:JODI CHEN
Last Name:NIENABER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-258-9635
Mailing Address - Fax:828-258-9682
Practice Address - Street 1:900 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1734
Practice Address - Country:US
Practice Address - Phone:828-213-7600
Practice Address - Fax:828-258-9682
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00472207R00000X, 207RI0200X, 207R00000X, 207RI0200X
MN53631207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGMedicare PIN
MNENROLLEDMedicaid
MN440000298Medicare PIN
NCPENDINGMedicaid