Provider Demographics
NPI:1407478688
Name:LESSARD, NIAH M (BS)
Entity Type:Individual
Prefix:
First Name:NIAH
Middle Name:M
Last Name:LESSARD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 656
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-0656
Mailing Address - Country:US
Mailing Address - Phone:414-807-6677
Mailing Address - Fax:
Practice Address - Street 1:10346 PARK MEADOWS DR
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6870
Practice Address - Country:US
Practice Address - Phone:720-473-3049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker