Provider Demographics
NPI:1437618337
Name:NIEMEYER, OLIVIA BETH (FNP-C)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:BETH
Last Name:NIEMEYER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 HEGG DR
Mailing Address - Street 2:
Mailing Address - City:ROCK VALLEY
Mailing Address - State:IA
Mailing Address - Zip Code:51247-1445
Mailing Address - Country:US
Mailing Address - Phone:712-476-8100
Mailing Address - Fax:712-476-8064
Practice Address - Street 1:1202 21ST AVE
Practice Address - Street 2:
Practice Address - City:ROCK VALLEY
Practice Address - State:IA
Practice Address - Zip Code:51247-1497
Practice Address - Country:US
Practice Address - Phone:712-476-8100
Practice Address - Fax:712-476-8064
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA154091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily