Provider Demographics
NPI:1376980060
Name:NIED, ANDREA SUE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SUE
Last Name:NIED
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14575 W 64TH AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3546
Mailing Address - Country:US
Mailing Address - Phone:720-500-7450
Mailing Address - Fax:
Practice Address - Street 1:14575 W 64TH AVE UNIT B
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3546
Practice Address - Country:US
Practice Address - Phone:720-500-7450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist