Provider Demographics
NPI:1326094145
Name:NIEMANN ROYER, NANCY JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JANE
Last Name:NIEMANN ROYER
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2 PROGRESS POINT PARKWAY
Mailing Address - Street 2:PROGRESS WEST HEALTH CARE CENTER ATTN ER
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368
Mailing Address - Country:US
Mailing Address - Phone:636-344-1151
Mailing Address - Fax:636-344-1176
Practice Address - Street 1:2 PROGRESS POINT PARKWAY
Practice Address - Street 2:PROGRESS WEST HEALTH CARE CENTER ATTN ER
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368
Practice Address - Country:US
Practice Address - Phone:636-344-1151
Practice Address - Fax:636-344-1176
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR9E46207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207810318Medicaid
MO208705198Medicare PIN
MO207810318Medicaid
E36375Medicare UPIN