Provider Demographics
NPI:1568010528
Name:NIEMAN, ABIGAIL OVERHOLT (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:OVERHOLT
Last Name:NIEMAN
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320B TAZEWELL PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2703
Mailing Address - Country:US
Mailing Address - Phone:865-237-6829
Mailing Address - Fax:
Practice Address - Street 1:2100 CLINCH AVE STE 510
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2225
Practice Address - Country:US
Practice Address - Phone:865-546-3998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN230985208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics