Provider Demographics
NPI:1497322119
Name:NIESE, DANIELLE LYNN (RN, BSN, WCC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LYNN
Last Name:NIESE
Suffix:
Gender:F
Credentials:RN, BSN, WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 PUTNAM PKWY
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-8657
Mailing Address - Country:US
Mailing Address - Phone:419-523-4092
Mailing Address - Fax:
Practice Address - Street 1:147 PUTNAM PKWY
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-8657
Practice Address - Country:US
Practice Address - Phone:419-523-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374540364SL0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care